MEDICARE: TERRIE LYN PASCH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	4949	AZ
2	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447536180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRIE LYN PASCH PA-C

Provider Business Mailing Address
First Line	:	13203 N 103RD AVE
Second Line	:	STE H5
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3032
Country	:	US
Telephone Number	:	623-334-4000
Fax Number	:	623-334-4400

Provider Business Practice Location Address
First Line	:	13203 N 103RD AVE STE H5
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3032
Country	:	US
Telephone Number	:	623-777-4747
Fax Number	:	623-777-4748

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2011
Last Update Date	:	05/11/2021

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Directions to “ TERRIE LYN PASCH PA-C” Practice Location

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