Provider Demographics
NPI:1588061931
Name:EXIME, SHERLEY LISA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHERLEY
Middle Name:LISA
Last Name:EXIME
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHERLEY
Other - Middle Name:LISA
Other - Last Name:CASSEUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2030 THISTLE HILL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-1159
Mailing Address - Country:US
Mailing Address - Phone:717-225-9869
Mailing Address - Fax:
Practice Address - Street 1:2030 THISTLE HILL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1159
Practice Address - Country:US
Practice Address - Phone:717-225-9869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA420257ZEA5Medicare PIN