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General NPI Number Information
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NPI Number | 1457375032
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Entity Type | Individual
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Provider Name | MARISSA ANN EDWARDS P.A.C.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 899 POPLAR CHURCH RD
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City | CAMP HILL
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State | PA
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Zip | 17011-2206
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Country | US
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Telephone | 717-763-0430
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Fax | 717-763-9854
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Provider Business Mailing Address
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Address Line | 899 POPLAR CHURCH RD
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City | CAMP HILL
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State | PA
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Zip | 17011-2206
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Country | US
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Telephone | 177-630-4307
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Fax | 717-763-9854
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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 | MA060596
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License Number State | PA
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