Provider Demographics
NPI:1477659837
Name:HECK, CHERYL LYNNE (PA-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNNE
Last Name:HECK
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:CAPRICORN HEALTH LLC 101 CHESAPEAKE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921
Mailing Address - Country:US
Mailing Address - Phone:410-398-0590
Mailing Address - Fax:
Practice Address - Street 1:CAPRICORN HEALTH, LLC 101 CHESAPEAKE BLVD, SUITE B
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921
Practice Address - Country:US
Practice Address - Phone:410-398-0590
Practice Address - Fax:443-707-2070
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000790363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant