MEDICARE: MISS CHELSEA MARIE LARRIMER 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	MA058074	PA

General Provider Information

NPI Number	:	1609235027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHELSEA MARIE LARRIMER PA-C

Provider Business Mailing Address
First Line	:	1624 PACIFIC AVE STE B
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2145
Country	:	US
Telephone Number	:	724-226-3345
Fax Number	:	724-226-2415

Provider Business Practice Location Address
First Line	:	1624 PACIFIC AVE STE B
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2145
Country	:	US
Telephone Number	:	724-226-3345
Fax Number	:	724-226-2415

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

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	07/21/2022

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