Provider Demographics
NPI:1982707246
Name:SEARS, THERESA LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:SEARS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:131 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-5402
Mailing Address - Country:US
Mailing Address - Phone:304-872-6503
Mailing Address - Fax:304-872-5415
Practice Address - Street 1:804 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:MAXWELTON
Practice Address - State:WV
Practice Address - Zip Code:24957-8066
Practice Address - Country:US
Practice Address - Phone:304-497-0500
Practice Address - Fax:304-497-0516
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002363363AM0700X
WV01055363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical