Healthcare Provider Details

I. General information

NPI: 1033776984
Provider Name (Legal Business Name): MORGAN A HEROLD PA-C, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5360 LINCOLN HWY STE 15
GAP PA
17527-9461
US

IV. Provider business mailing address

5360 LINCOLN HWY STE 15
GAP PA
17527-9461
US

V. Phone/Fax

Practice location:
  • Phone: 717-442-8111
  • Fax:
Mailing address:
  • Phone: 717-442-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA068350
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberRT006820
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: