MEDICARE: PAULA MILLER PAC

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	MA003532L	PA
2	363A00000X	Physician Assistant	OA002003	PA

General Provider Information

NPI Number	:	1891797791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA MILLER PAC

Provider Business Mailing Address
First Line	:	1201 GRAMPIAN BLVD
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-1900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 E WATER ST
Second Line	:
City	:	MUNCY
State	:	PA
Zip	:	17756-8828
Country	:	US
Telephone Number	:	570-321-2850
Fax Number	:

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	04/17/2025

Similar Medicare Providers

1568510519 — DR. MARK D. BEYER D.O.
Practice Location Address:

215 E WATER ST , MUNCY VALLEY HOSPITAL
MUNCY, PA
17756-8828

Practice Phone: 570-546-4201
Practice Fax:

1023079506 — MANUEL V MORENO MD
Practice Location Address:

215 E WATER ST
MUNCY, PA
17756-8828

Practice Phone: 570-546-4243
Practice Fax:

1639134844 — GEORGE ALDEN MANCHESTER M.D.
Practice Location Address:

215 E WATER ST
MUNCY, PA
17756-8828

Practice Phone: 570-546-4209
Practice Fax:

1467410340 — MS. KELLY S. SHULTZ CRNP
Practice Location Address:

215 E WATER ST , SUSQUEHANNA HEALTH SKILLED NURSING & REHAB CENTER
MUNCY, PA
17756-8828

Practice Phone: 570-546-4040
Practice Fax: 570-546-4095

1801840566 — MR. ALLAN P. TIDWELL PA-C
Practice Location Address:

215 E WATER ST
MUNCY, PA
17756-8828

Practice Phone: 570-321-2850
Practice Fax: 570-321-2851

1629024278 — DR. JOSEPH J LEXON MD
Practice Location Address:

215 E WATER ST , MVH ED
MUNCY, PA
17756-8828

Practice Phone: 570-546-4201
Practice Fax: 570-546-4038

Directions to “ PAULA MILLER PAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.