Provider Demographics
NPI:1689745671
Name:HERBSTER, MICHELLE ANN GUY (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN GUY
Last Name:HERBSTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WASHINGTON RD STE 7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2765
Mailing Address - Country:US
Mailing Address - Phone:724-225-3627
Mailing Address - Fax:724-225-1234
Practice Address - Street 1:460 WASHINGTON RD STE 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2765
Practice Address - Country:US
Practice Address - Phone:724-225-3627
Practice Address - Fax:724-225-1234
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052624363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant