Individual
JACQUELINE ANN WEVODAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA
Contact information
Practice address
2005 TECHNOLOGY PKWY STE 400, MECHANICSBURG, PA 17050
(717) 791-2520
(717) 703-0061
Mailing address
5885 AVIS LANE, HARRISBURG, PA 17112-1606
(717) 602-8204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103148481
—
PA
Enumeration date
10/12/2006
Last updated
08/12/2025
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