Provider Demographics
NPI:1679541684
Name:GESSNER, AIMEE LYNN (PA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:LYNN
Last Name:GESSNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GESSNER WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-1535
Mailing Address - Country:US
Mailing Address - Phone:570-473-7017
Mailing Address - Fax:
Practice Address - Street 1:5 GESSNER WAY
Practice Address - Street 2:
Practice Address - City:NORTHUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17857-1535
Practice Address - Country:US
Practice Address - Phone:570-473-7017
Practice Address - Fax:570-473-7014
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051573363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q09843Medicare UPIN
PAP00231474Medicare PIN
PA077059Medicare PIN
PAP00231474Medicare PIN
PA077059Medicare PIN