Provider Demographics
NPI:1558770701
Name:SIEMINKEWICZ, HEATHER (PA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SIEMINKEWICZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9016
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:120 IRMC DR STE 130
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3674
Practice Address - Country:US
Practice Address - Phone:724-471-7100
Practice Address - Fax:724-471-7111
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2021-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA056909363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant