Provider Demographics
NPI:1609494103
Name:STAHL, HEATHER (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:STAHL
Suffix:
Gender:F
Credentials:PA-C
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:155 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9509
Mailing Address - Country:US
Mailing Address - Phone:814-619-1712
Mailing Address - Fax:
Practice Address - Street 1:1 TECH PARK DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2515
Practice Address - Country:US
Practice Address - Phone:814-475-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant