Provider Demographics
NPI:1689959355
Name:DYER, CHELSEA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANNE
Last Name:DYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANNE
Other - Last Name:SPRAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-733-0311
Mailing Address - Fax:
Practice Address - Street 1:169 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1724
Practice Address - Country:US
Practice Address - Phone:717-733-0311
Practice Address - Fax:717-738-6735
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005768363AM0700X
VA0110005346363AM0700X
PAMA055264363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical