Provider Demographics
NPI:1326033044
Name:ROHRER, HEATHER L (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:ROHRER
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 1:3233 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1938
Mailing Address - Country:US
Mailing Address - Phone:702-410-8450
Mailing Address - Fax:702-410-8456
Practice Address - Street 1:3233 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1938
Practice Address - Country:US
Practice Address - Phone:702-410-8450
Practice Address - Fax:702-410-8456
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA789363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1326033044Medicaid
NV1326033044Medicaid
NVBL518ZMedicare PIN