Provider Demographics
NPI:1740280296
Name:SCURFIELD, KELLI L (PA-C)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:L
Last Name:SCURFIELD
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:880 CENTURY DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4375
Practice Address - Country:US
Practice Address - Phone:717-737-4718
Practice Address - Fax:717-909-0902
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000481L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
602326Medicare ID - Type Unspecified
R07508Medicare UPIN