Provider Demographics
NPI:1134195852
Name:BIXLER, LINDSEY RAE (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:BIXLER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:RAE
Other - Last Name:WIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:105 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:PA
Practice Address - Zip Code:17983-9423
Practice Address - Country:US
Practice Address - Phone:570-682-8026
Practice Address - Fax:570-682-8043
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002216363A00000X
PAMA052329363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA116574F6KMedicare PIN
PAQ56147Medicare UPIN