Provider Demographics
NPI:1487653879
Name:SANDERS, TRISHA LOUISE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LOUISE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:LOUISE
Other - Last Name:PIPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 BEACOM DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9658
Mailing Address - Country:US
Mailing Address - Phone:724-728-4941
Mailing Address - Fax:
Practice Address - Street 1:1000 DUTCH RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9727
Practice Address - Country:US
Practice Address - Phone:724-773-1416
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001931L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS35094Medicare UPIN