Provider Demographics
NPI:1487005112
Name:LAMPRON, HEATHER
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LAMPRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 5TH STREET HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1739
Mailing Address - Country:US
Mailing Address - Phone:610-208-8800
Mailing Address - Fax:610-898-1336
Practice Address - Street 1:4301 5TH STREET HWY
Practice Address - Street 2:STE 100
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1739
Practice Address - Country:US
Practice Address - Phone:610-208-8800
Practice Address - Fax:610-898-1336
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016034363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner