Provider Demographics
NPI:1659473692
Name:STOOR-BURNING, ERICKA LEA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ERICKA
Middle Name:LEA
Last Name:STOOR-BURNING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERICKA
Other - Middle Name:LEA
Other - Last Name:STOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2875
Mailing Address - Fax:717-334-3921
Practice Address - Street 1:455 S WASHINGTON ST STE 12
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2516
Practice Address - Country:US
Practice Address - Phone:717-339-2875
Practice Address - Fax:717-334-3921
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00083500363A00000X
IL085004536363A00000X
PAMA053070363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q21181Medicare UPIN
080436US4Medicare PIN