Provider Demographics
NPI:1710964861
Name:REIN, JESSICA SCHAFFER (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SCHAFFER
Last Name:REIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNNE
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 SPRINT DR STE 1
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7002
Mailing Address - Country:US
Mailing Address - Phone:717-701-8251
Mailing Address - Fax:717-701-8289
Practice Address - Street 1:19 SPRINT DR STE 1
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015
Practice Address - Country:US
Practice Address - Phone:717-701-8251
Practice Address - Fax:717-701-8289
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052172363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA093888Medicare ID - Type UnspecifiedMEDICARE ID JESSICA
PAQ50393Medicare UPIN