ANDREA LYNNE LACKI (NPI# 1215057799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215057799 |
| Entity Type | Individual |
| Full Name | ANDREA LYNNE LACKI |
| Credential | PA-C |
| Practice Address |
3000 Fairway Dr Altoona PA 16602-4472 |
| Mailing Address |
614 N Terrace Dr Altoona PA 16602-2965 |
| Practice Telephone | 8149621166 |
| Mailing Telephone | 8144414861 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2010-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 0110002349 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA053507 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C0003589 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3000 FAIRWAY DR |
| City | ALTOONA |
| State | PA |
| Zip Code | 16602-4472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790755676 | Brett J Beech | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2006-01-24 |
| 1528576410 | Megan Winters | Physical Therapist | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2018-01-13 |
| 1932568532 | University Orthopedics Center, Ltd. | Durable Medical Equipment & Medical Supplies | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2016-02-11 |
| 1982087037 | Joshua R Greenleaf | Orthopaedic Surgery | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2015-07-08 |
| 1013396670 | Joshua Augustine Muetzel | Family Medicine | 3000 Fairway Dr, Altoona, PA 16602 | 2015-05-28 |
| 1356779185 | Brett Kudlawiec | Physical Therapist | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2013-10-14 |
| 1528300241 | Vanessa R Colquhoun | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2013-03-20 |
| 1700140753 | David S Claar | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2012-06-25 |
| 1942598842 | Anthony C Damin | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2011-07-13 |
| 1306133426 | Shannon Scanlan | Physical Therapist | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2011-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817646 | John Francis Cain | Registered Nurse | 319 Meadowlark Ave, Altoona, PA 16602 | 2020-10-06 |
| 1023650991 | Rahaf Obeid | Pharmacist | 508 E Plank Road, Altoona, PA 16602 | 2019-10-12 |
| 1346713641 | Justin M Delasko | Dietitian, Registered | 905 Logan Blvd, Altoona, PA 16602 | 2019-01-09 |
| 1679932420 | Dottie Jean Morgan | Speech-Language Pathologist | 501 Valley View Blvd., Altoona, PA 16602 | 2016-02-22 |
| 1922409283 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1600 9th Avenue, Altoona, PA 16602 | 2014-09-05 |
| 1972918878 | Grane Hospice Care, Inc. | Hospice Care, Community Based | 115 Union Ave Ste 100, Altoona, PA 16602 | 2014-06-30 |
| 1033524921 | Grane Hospice Care, Inc. | Home Health | 115 Union Ave Ste 300, Altoona, PA 16602 | 2014-06-30 |
| 1306184858 | Lighthouse Medical, LLC | Physical Medicine & Rehabilitation | 301 E. Pleasant Valley Blvd, Altoona, PA 16602 | 2013-01-17 |
| 1497042576 | Michala Seidel | Counselor | 3010 7th Avenue, Alternative Community Resource Program, Altoona, PA 16602 | 2011-07-08 |
| 1205121647 | Rebekah Brown | Preventive Medicine | 301 E Pleasant Valley Blvd., Altoona, PA 16602 | 2011-06-14 |
| Find all providers in zip 16602 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295182491 | Emily Tercek | Physician Assistant | 620 Howard Ave Fl 7, Altoona, PA 16601-4804 | 2016-05-17 |
| 1356303358 | Gilbert H Johnson | Physician Assistant | 1304 Lake Rd, Altoona, WI 54720-1849 | 2006-04-05 |
| 1346200995 | Stephen F Pyo | Physician Assistant | 1505 9th Ave, Altoona, PA 16602-2416 | 2006-03-27 |
| 1841801651 | Kristin Mathiowetz | Physician Assistant | 3119 Woodman Dr, Altoona, WI 54720-2668 | 2020-08-14 |
| 1700432358 | Rebecca Gorba | Physician Assistant | 620 Howard Ave, Altoona, PA 16601-4804 | 2019-08-09 |
| 1003474198 | Sean Allen Yeckley | Physician Assistant | 620 Howard Ave, Altoona, PA 16601-4804 | 2019-06-03 |
| 1669986246 | Kaylee Kowalczyk | Physician Assistant | 620 Howard Ave, Altoona, PA 16601-4804 | 2017-11-19 |
| 1528300241 | Vanessa R Colquhoun | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2013-03-20 |
| 1700140753 | David S Claar | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2012-06-25 |
| 1942598842 | Anthony C Damin | Physician Assistant | 3000 Fairway Dr, Altoona, PA 16602-4472 | 2011-07-13 |
| Find all providers in ALTOONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.