Basic Information
| Provider Information | |||||||||
| NPI: | 1063821338 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUCEY | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | KYLE | ||||||||
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| Credential: | CPNP-PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 ST PAUL DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177097922 | ||||||||
| FaxNumber: | 7172632055 | ||||||||
| Practice Location | |||||||||
| Address1: | 830 5TH AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177097950 | ||||||||
| FaxNumber: | 7172638898 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | SP014512 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.