Provider Demographics
NPI:1245481787
Name:MARSHALL, HILLARY A (MPA, PA-C)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:A
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MPA, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:300 E MAIN ST
Mailing Address - Street 2:PO BOX 189
Mailing Address - City:REYNOLDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15851-1282
Mailing Address - Country:US
Mailing Address - Phone:814-375-6071
Mailing Address - Fax:814-375-6073
Practice Address - Street 1:20 INDUSTRIAL DR
Practice Address - Street 2:ACUTE CARE CLINIC
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3842
Practice Address - Country:US
Practice Address - Phone:814-375-6071
Practice Address - Fax:814-375-6073
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2011-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053568363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA136991Medicare PIN