Provider Demographics
NPI:1336337948
Name:KLIEWER, ASHLEY R (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:KLIEWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:R
Other - Last Name:GRAEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-8144
Mailing Address - Fax:717-544-8140
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-8144
Practice Address - Fax:717-544-8140
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00731818OtherRR MEDICARE
PA50085387OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PAP00731818OtherRR MEDICARE