Provider Demographics
NPI:1851289953
Name:BITTNER, MAKENNA MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:MAKENNA
Middle Name:MICHELLE
Last Name:BITTNER
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 1:342 HAAGEN LN
Mailing Address - Street 2:
Mailing Address - City:BEECH CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16822-7301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:226 BUCKAROO LN
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-9120
Practice Address - Country:US
Practice Address - Phone:800-230-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant