Healthcare Provider Details

I. General information

NPI: 1891033551
Provider Name (Legal Business Name): KELLY MARISA HESS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MARISA BARNHOUSE

II. Dates (important events)

Enumeration Date: 01/30/2013
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SNYDER RD
DONEGAL PA
15628-9704
US

IV. Provider business mailing address

212 SNYDER RD
DONEGAL PA
15628-9704
US

V. Phone/Fax

Practice location:
  • Phone: 724-252-4458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA055984
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: