Healthcare Provider Details

I. General information

NPI: 1447815626
Provider Name (Legal Business Name): ASHLEE GRACE METZGER PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 4TH ST
EAST BERLIN PA
17316-9638
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-4900
  • Fax: 717-255-0951
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA060611
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: