Provider Demographics
NPI:1457778003
Name:BERINGER, HOLLY ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:BERINGER
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 1:161 WILMINGTON W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9041
Mailing Address - Country:US
Mailing Address - Phone:610-361-1060
Mailing Address - Fax:
Practice Address - Street 1:1815 W 13TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4054
Practice Address - Country:US
Practice Address - Phone:302-652-4705
Practice Address - Fax:302-652-2917
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000963363A00000X
PAMA056754363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical