Provider Demographics
NPI:1578838488
Name:SCHUSTER, HEATHER RENEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:SCHUSTER
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 1:1502 CREIGHTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7143
Mailing Address - Country:US
Mailing Address - Phone:850-437-3777
Mailing Address - Fax:850-437-3318
Practice Address - Street 1:1502 CREIGHTON RD STE A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7143
Practice Address - Country:US
Practice Address - Phone:850-437-3777
Practice Address - Fax:850-437-3318
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA07689363AS0400X
FLPA9114143363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377129YKPWMedicare PIN