Individual
COURTNEY A AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
25 MONUMENT RD, SUITE 190, YORK, PA 17403-5060
(717) 851-6454
(717) 851-1665
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-6454
(717) 851-1665
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA053691
PA
363AM0700X
Medical Physician Assistant
Primary
MA053691
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1577734
GATEWAY-WMG
PA
01
—
2075004
HIGHMARK BLUE SHIELD
PA
01
—
50081020
CAPITAL BLUE CROSS-WMG
PA
Enumeration date
10/09/2008
Last updated
01/30/2014
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