Provider Demographics
NPI:1760900245
Name:GOATES, VALERIE FRANDSEN (PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:FRANDSEN
Last Name:GOATES
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 1:103 N BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17065-1202
Mailing Address - Country:US
Mailing Address - Phone:717-960-0052
Mailing Address - Fax:
Practice Address - Street 1:103 N BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17065-1202
Practice Address - Country:US
Practice Address - Phone:717-960-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004217363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant