Provider Demographics
NPI:1609115161
Name:PANE, ASHLEY NICOLE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:PANE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:KERAMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1259 S CEDAR CREST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6373
Mailing Address - Country:US
Mailing Address - Phone:610-437-4134
Mailing Address - Fax:610-770-0993
Practice Address - Street 1:236 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8937
Practice Address - Country:US
Practice Address - Phone:610-437-4134
Practice Address - Fax:610-433-9690
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-004144363AM0700X
PAMA060760363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical