Healthcare Provider Details

I. General information

NPI: 1326371865
Provider Name (Legal Business Name): MARIE JAMIE FLUKE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE JAMIE GEIGER PA-C

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 N RAILROAD ST
TAMAQUA PA
18252-1330
US

IV. Provider business mailing address

143 N RAILROAD ST
TAMAQUA PA
18252-1330
US

V. Phone/Fax

Practice location:
  • Phone: 570-645-1540
  • Fax: 866-230-8954
Mailing address:
  • Phone: 570-645-1540
  • Fax: 866-230-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA054093
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: