Provider Demographics
NPI:1962419671
Name:HARPER, ALICIA CAROL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:CAROL
Last Name:HARPER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ALICIA
Other - Middle Name:CAROL
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:812 GORMAN AVE OFC
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3181
Mailing Address - Country:US
Mailing Address - Phone:304-636-3300
Mailing Address - Fax:
Practice Address - Street 1:801 GORMAN AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3147
Practice Address - Country:US
Practice Address - Phone:304-636-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV963363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001722347OtherBC/BS NUMBER
WV0098351000Medicaid
WV0098351000Medicaid
P84372Medicare UPIN
WVPA20801Medicare PIN