Provider Demographics
NPI:1932185428
Name:SPINELL, AMY H (PA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:H
Last Name:SPINELL
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 1:161 OLD SCHOOLHOUSE LN
Mailing Address - Street 2:STE 3
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5684
Mailing Address - Country:US
Mailing Address - Phone:717-691-7100
Mailing Address - Fax:717-691-6855
Practice Address - Street 1:49 PRINCE ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-3113
Practice Address - Country:US
Practice Address - Phone:717-901-3440
Practice Address - Fax:717-901-3447
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA052195OtherPA STATE LICENSE
PAMA052195OtherPA STATE LICENSE
PA099274Medicare PIN