Provider Demographics
NPI:1710925482
Name:MOYER, CARRIE S (PA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:S
Last Name:MOYER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:S
Other - Last Name:TRIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
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:717-851-2441
Mailing Address - Fax:717-260-3322
Practice Address - Street 1:30 MONUMENT RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5024
Practice Address - Country:US
Practice Address - Phone:717-851-2441
Practice Address - Fax:717-260-3322
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA0027451363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03273401OtherCAPITAL BLUECROSS
PA2504226OtherHIGHMARK BCBS
PAP00265675OtherRAILROAD MEDICARE
PA020092FHKMedicare PIN
PA2504226OtherHIGHMARK BCBS
PAP00265675OtherRAILROAD MEDICARE
S82864Medicare UPIN