Individual
ELENA M HIERSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 SENECA ST STE 646C, BUFFALO, NY 14210-1351
(716) 995-4450
Mailing address
201 COX BLVD, GOLDSBORO, NC 27534-9479
(919) 735-7580
(919) 580-9338
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03780
NC
363A00000X
Physician Assistant
Primary
PA170371
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780934091
BCBS
NC
05
—
8102812
—
NC
Enumeration date
09/13/2012
Last updated
03/07/2023
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