Provider Demographics
NPI:1982667671
Name:STABLEY, AIMEE JOYCE (PA-C)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:JOYCE
Last Name:STABLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:JOYCE
Other - Last Name:EARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:125 FEDERAL WALK
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1866
Mailing Address - Country:US
Mailing Address - Phone:267-253-7475
Mailing Address - Fax:
Practice Address - Street 1:201 REECEVILLE RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1542
Practice Address - Country:US
Practice Address - Phone:610-383-8185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000504363A00000X
PAOA002105363A00000X
PAMA052530363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant