MEDICARE: VALERIE FRANDSEN GOATES 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	363A00000X	Physician Assistant	OA004217	PA

General Provider Information

NPI Number	:	1760900245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE FRANDSEN GOATES PA-C

Provider Business Mailing Address
First Line	:	103 N BALTIMORE AVE
Second Line	:
City	:	MOUNT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1202
Country	:	US
Telephone Number	:	717-960-0052
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 N BALTIMORE AVE
Second Line	:
City	:	MOUNT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1202
Country	:	US
Telephone Number	:	717-960-0052
Fax Number	:

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

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	07/21/2022

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