Provider Demographics
NPI:1104412253
Name:SHEAKLEY, ASHLEY M (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:SHEAKLEY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:LYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:9 NATHAN LN
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-6500
Practice Address - Country:US
Practice Address - Phone:717-639-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061677363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant