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NPI Code Detail

MEDICARE: MS. AVYNNE HESTER PA

MEDICARE:  MS. AVYNNE  HESTER  PA
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
1363A00000XPhysician Assistant25MP00198800NJ

General Provider Information

NPI Number : 1811338130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AVYNNE HESTER PA
Provider Business Mailing Address
First Line : 2559 AMBER ST APT 209
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-1768
Country : US
Telephone Number : 732-682-0668
Fax Number :
Provider Business Practice Location Address
First Line : 1701 JOHN TIPTON BLVD
Second Line :
City : PENNSAUKEN
State : NJ
Zip : 08110-1405
Country : US
Telephone Number : 856-406-4755
Fax Number : 856-662-2316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2013
Last Update Date : 10/21/2021

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Directions to “ MS. AVYNNE HESTER PA” Practice Location

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