Provider Demographics
NPI:1700892965
Name:NEMEC, ROXANNA H (PA)
Entity Type:Individual
Prefix:
First Name:ROXANNA
Middle Name:H
Last Name:NEMEC
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:717-339-3110
Mailing Address - Fax:717-339-3108
Practice Address - Street 1:450 S WASHINGTON ST FL 3
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325
Practice Address - Country:US
Practice Address - Phone:717-339-3110
Practice Address - Fax:717-339-3108
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002794363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD120NM431Medicare ID - Type Unspecified