Provider Demographics
NPI:1114967379
Name:HECKMAN, LINDA D (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1416
Mailing Address - Country:US
Mailing Address - Phone:610-525-5250
Mailing Address - Fax:610-525-2335
Practice Address - Street 1:569 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1416
Practice Address - Country:US
Practice Address - Phone:610-525-5250
Practice Address - Fax:610-525-2335
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002884L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA551563Medicare UPIN