Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. THERESA MICKNICK, PAC
ActiveMRS. THERESA MICKNICK, PAC is a Medical Physician Assistant healthcare provider located in CARBONDALE, Pennsylvania. NPI 1164774261 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · CARBONDALE, PA
Registration Details
- NPI Number
- 1164774261
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 12, 2012 (13.835380660745 yrs)
- Last Updated
- Oct 12, 2012
- License
-
MA001651L (PA)
Practice Information
- Address
-
165 FALLBROOK STCARBONDALE, PA, 18433Browse PA providers · Browse ZIP 18433
- Phone
- 5702823151
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in CARBONDALE, PA
| Name | Credential | NPI |
|---|---|---|
| MRS. ANN BRIDGET DIEHL | PA-C | 1093025272 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.