Provider Demographics
NPI:1477847465
Name:WRIGHT, HEATHER R (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:STEEPLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 112727
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-2727
Mailing Address - Country:US
Mailing Address - Phone:352-273-7002
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 112727
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2727
Practice Address - Country:US
Practice Address - Phone:352-273-7002
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105944363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003912100Medicaid
FLFD507WMedicare PIN