MEDICARE: MRS. BRITTANY MARIE HERBER 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

General Provider Information

NPI Number	:	1336754639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITTANY MARIE HERBER PA-C

Provider Business Mailing Address
First Line	:	22 SOLOMONS CT
Second Line	:
City	:	HEDGESVILLE
State	:	WV
Zip	:	25427-3683
Country	:	US
Telephone Number	:	304-283-9426
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 SOMERSET BLVD STE 101
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3954
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:	304-724-0053

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

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	04/21/2022

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