Provider Demographics
NPI:1326694175
Name:HEGEDTY, CAROLE LEIGH (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:LEIGH
Last Name:HEGEDTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:LEIGH
Other - Last Name:CZEPIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:2631 US 11
Practice Address - Street 2:
Practice Address - City:NICHOLSON
Practice Address - State:PA
Practice Address - Zip Code:18446-0591
Practice Address - Country:US
Practice Address - Phone:570-942-6707
Practice Address - Fax:570-942-6708
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020520207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine