Provider Demographics
NPI:1942669262
Name:HEALEY, GEORGIA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ANN
Last Name:HEALEY
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 1:746 JEFFERSON AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1624
Mailing Address - Country:US
Mailing Address - Phone:570-342-1776
Mailing Address - Fax:570-963-2049
Practice Address - Street 1:743 JEFFERSON AVE STE 305
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1639
Practice Address - Country:US
Practice Address - Phone:570-342-1776
Practice Address - Fax:570-207-1910
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-002808L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical