Individual provider · NPI-1

Heather Nicole Bailey, PA-C

Physician Assistant, Medical · Lebanon, PA

NPI number1801269642
StatusActive
Last updated in NPPESNov 2, 2015

Details

NPI
1801269642
Entity type
Individual (NPI-1)
Name
Mrs. Heather Nicole Bailey
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Nov 2, 2015
Last updated
Nov 2, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, MedicalMA057998PAYes
363A00000X Physician AssistantOA003692PA

Other names

  • Heather Nicole Love (Former Name)

Practice location

1010 W Crestview Dr
Lebanon, PA 17042-7415

Phone 717-272-7469

Mailing address

1010 W Crestview Dr
Lebanon, PA 17042-7415

Phone 717-272-7469

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