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General NPI Number Information
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NPI Number | 1295328953
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Entity Type | Individual
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Provider Name | JESSICA ASHLEY ERTEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/14/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 301 S 7TH AVE STE 365
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City | WEST READING
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State | PA
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Zip | 19611-1436
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Country | US
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Telephone | 484-628-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 301 S 7TH AVE STE 365
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City | WEST READING
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State | PA
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Zip | 19611-1436
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Country | US
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Telephone | 610-207-6602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA062323
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA062323
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License Number State | PA
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