Provider Demographics
NPI:1598103798
Name:WILLS, FAYE A (PA-C)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:A
Last Name:WILLS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:A
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 E CHESTER PIKE
Mailing Address - Street 2:TAYLOR HOSPITAL ACUTE REHABILITATION, 4TH FLR
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 E CHESTER PIKE
Practice Address - Street 2:TAYLOR HOSPITAL ACUTE REHABILITATION, 4TH FLR
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2212
Practice Address - Country:US
Practice Address - Phone:610-595-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant