Provider Demographics
NPI:1922383918
Name:ROUTSON, TARYN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:ELIZABETH
Last Name:ROUTSON
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 1:300 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2297
Practice Address - Country:US
Practice Address - Phone:717-316-3711
Practice Address - Fax:717-316-3049
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003667363AM0700X
PAMA055157363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2677098OtherHIGHMARK BLUE SHIELD - FREEDOM BLUE
PA1602799OtherGATEWAY MEDICARE ASSURED
PA1602799OtherGATEWAY MEDICARE ASSURED
PA2677098OtherHIGHMARK BLUE SHIELD - FREEDOM BLUE