Provider Demographics
NPI:1437113768
Name:HEIMBACH, VANESSA K (PAC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:K
Last Name:HEIMBACH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3445 HIGH POINT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:610-866-5555
Mailing Address - Fax:610-866-2006
Practice Address - Street 1:3445 HIGH POINT BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-866-5555
Practice Address - Fax:610-866-2006
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051921363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant