Provider Demographics
NPI:1629758560
Name:GARVEY, AMANDA LYNNE (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNNE
Last Name:GARVEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LYNNE
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 PENN ST STE D
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1956
Mailing Address - Country:US
Mailing Address - Phone:717-632-0774
Mailing Address - Fax:717-633-5816
Practice Address - Street 1:112 CLOVER LN
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4321
Practice Address - Country:US
Practice Address - Phone:717-637-7812
Practice Address - Fax:717-637-5893
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA064658363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA064658OtherPENNSYLVANIA STATE LICENSE