Healthcare Provider Details

I. General information

NPI: 1568886711
Provider Name (Legal Business Name): HANNAH M WILSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2014
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 STRICKLER RD SUITE 100
MOUNT JOY PA
17552-9321
US

IV. Provider business mailing address

1475 STRICKLER RD SUITE 100
MOUNT JOY PA
17552-9321
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-8690
  • Fax: 717-544-8691
Mailing address:
  • Phone: 717-544-8690
  • Fax: 717-544-8691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA056714
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: