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Individual

MISS DANA LEIGH WIESENFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6 N DORCAS ST, LEWISTOWN, PA 17044-1737
(717) 953-9571
(717) 953-9576
Mailing address
6 N DORCAS ST, LEWISTOWN, PA 17044-1737
(717) 953-9571
(717) 953-9576

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107626
FL
363AM0700X
Medical Physician Assistant
PA9107626
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010979900
FL
01
3EOZF
BCBS
FL
01
5009736.
AVMED
FL
01
5181955
AETNA
FL
01
8KL5R
BCBS
FL
01
P01744113
RR MEDICARE
FL
01
P1046279
FREEDOM
FL
01
P979555
OPTIMUM
FL
Enumeration date
11/25/2013
Last updated
08/10/2022
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