Provider Demographics
NPI:1942214481
Name:SCHMERSAL, AMY LYNN (PAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SCHMERSAL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1042
Mailing Address - Country:US
Mailing Address - Phone:724-495-2371
Mailing Address - Fax:
Practice Address - Street 1:1030 BEANER HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9723
Practice Address - Country:US
Practice Address - Phone:724-770-0410
Practice Address - Fax:724-770-0414
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001708L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S54132Medicare UPIN
006292FENMedicare ID - Type Unspecified