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49 Prince St Harrisburg PA 17109-3113 | |
| (717) 901-3440 | |
| (717) 901-3447 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 49 Prince St, Harrisburg, Pennsylvania |
| Authorized Official Name and Position | Richard M Rayner (OWNER) |
| Authorized Official Contact | 7179013440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
49 Prince St Harrisburg PA 17109-3113 Ph: (717) 901-3440 | 49 Prince St Harrisburg PA 17109-3113 Ph: (717) 901-3440 |
| NPI Number | 1225278922 |
|---|---|
| Provider Enumeration Date | 02/20/2009 |
| Last Update Date | 08/31/2024 |
| Medicare PECOS PAC ID | 5991854168 |
|---|---|
| Medicare Enrollment ID | O20090518000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225278922 | NPI | - | NPPES |
| Provider Name | Edwin Lee Robles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437197423 PECOS PAC ID: 1658362926 Enrollment ID: I20040524001285 |
| Provider Name | Richard M Rayner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093770885 PECOS PAC ID: 1254305378 Enrollment ID: I20040824001104 |
| Provider Name | Lisa M Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588624571 PECOS PAC ID: 5597708925 Enrollment ID: I20050607000794 |
| Provider Name | David Allan White |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386730711 PECOS PAC ID: 2062314263 Enrollment ID: I20061018000511 |
| Provider Name | Joshua J Wethli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063710911 PECOS PAC ID: 3072799709 Enrollment ID: I20110516000036 |
| Provider Name | Valerie L Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194121707 PECOS PAC ID: 0648595058 Enrollment ID: I20150205002183 |
| Provider Name | Kelsey S Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285161687 PECOS PAC ID: 6800160482 Enrollment ID: I20170920001958 |
| Provider Name | Angela Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275083115 PECOS PAC ID: 5799050878 Enrollment ID: I20170929002120 |
| Provider Name | Denise L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548738370 PECOS PAC ID: 8729322318 Enrollment ID: I20181210000435 |
| Provider Name | Jennie Elizabeth Martini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902459951 PECOS PAC ID: 2860720828 Enrollment ID: I20190829000108 |
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