MRS. THERESA MICKNICK PAC
NPI 1164774261
Physician Assistant - Medical in Carbondale, PA
About Mrs. Theresa Micknick Pac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. THERESA MICKNICK PAC (NPI 1164774261) is an individual medical provider in Carbondale, Pennsylvania, licensed in Pennsylvania (MA001651L) and active in the NPI registry since October 2012.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Theresa Micknick's NPI number?
The NPI number for Theresa Micknick is 1164774261. It was assigned to this individual provider in the NPPES registry on October 12, 2012. The provider is also known as Mr. Theresa White Pac.
Where is Theresa Micknick located?
Theresa Micknick practices at 165 Fallbrook St, Carbondale, PA 18433. The listed phone number is (570) 282-3151.
What is Theresa Micknick's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
When was this NPI record last updated?
The NPPES record for Theresa Micknick was last updated on October 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
