Provider Demographics
NPI:1538643028
Name:HEUBEL, MEGHAN EMILY (MS)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:EMILY
Last Name:HEUBEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:MEGHAN
Other - Middle Name:EMILY
Other - Last Name:PANCZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:4 BELVIDERE ST APT 201
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2158
Mailing Address - Country:US
Mailing Address - Phone:610-462-7050
Mailing Address - Fax:
Practice Address - Street 1:2909 PA-100 #100
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069
Practice Address - Country:US
Practice Address - Phone:570-560-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003834174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist