Provider Demographics
NPI:1306218854
Name:MCGLYNN, HEATHER (CRNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MCGLYNN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4027
Mailing Address - Country:US
Mailing Address - Phone:302-543-6165
Mailing Address - Fax:
Practice Address - Street 1:26002 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-4948
Practice Address - Country:US
Practice Address - Phone:302-947-4200
Practice Address - Fax:717-846-8410
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-0010490207RG0300X
PASP015472363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA485397Medicare PIN