Provider Demographics
NPI:1811325608
Name:WURM, ALICIA M (PA-C)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:WURM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6560
Mailing Address - Fax:814-372-2848
Practice Address - Street 1:757 JOHNSONBURG RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3488
Practice Address - Country:US
Practice Address - Phone:814-834-2850
Practice Address - Fax:814-781-1580
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2016-11-08
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Provider Licenses
StateLicense IDTaxonomies
PAMA056509363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant