MEDICARE: JENNIFER ANN MERRIS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA060312	PA

General Provider Information

NPI Number	:	1336621614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN MERRIS PA-C

Provider Business Mailing Address
First Line	:	2108 HARRISBURG PIKE STE 200
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2644
Country	:	US
Telephone Number	:	717-299-1301
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 HARRISBURG PIKE STE 200
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-2644
Country	:	US
Telephone Number	:	717-299-1301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2018
Last Update Date	:	04/19/2026

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