Provider Demographics
NPI:1356873038
Name:HEATON, WENDY (DO)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:HEATON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 UNION DEPOSIT RD STE 140
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3774
Mailing Address - Country:US
Mailing Address - Phone:717-652-6605
Mailing Address - Fax:717-652-6431
Practice Address - Street 1:4700 UNION DEPOSIT RD STE 140
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3774
Practice Address - Country:US
Practice Address - Phone:717-652-6605
Practice Address - Fax:717-652-6431
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology