Healthcare Provider Details

I. General information

NPI: 1629537766
Provider Name (Legal Business Name): SARAH FIKSE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH HEADLEY

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N DUKE ST
LANCASTER PA
17602-2250
US

IV. Provider business mailing address

555 NORTH DUKE STREET
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-503-1179
  • Fax:
Mailing address:
  • Phone: 717-544-8144
  • Fax: 717-544-8140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA060514
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: