Provider Demographics
NPI:1720247810
Name:MINGEAR, DESIREE A (PA C)
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:A
Last Name:MINGEAR
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-3034
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:819 E BISHOP ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2319
Practice Address - Country:US
Practice Address - Phone:814-355-9743
Practice Address - Fax:814-353-3500
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053396363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant