Provider Demographics
NPI:1073840401
Name:SCHAPER, HEATHER ANN (PA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:SCHAPER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S 11TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4880
Mailing Address - Country:US
Mailing Address - Phone:208-232-7862
Mailing Address - Fax:208-232-7869
Practice Address - Street 1:306 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:ID
Practice Address - Zip Code:83210-0000
Practice Address - Country:US
Practice Address - Phone:208-397-4126
Practice Address - Fax:208-397-4176
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA824363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical