Provider Demographics
NPI:1811092232
Name:PILE, HEATHER M (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:PILE
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 1:700 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3756
Mailing Address - Country:US
Mailing Address - Phone:859-258-8530
Mailing Address - Fax:859-258-8515
Practice Address - Street 1:2424 SIR BARTON WAY STE 175
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2531
Practice Address - Country:US
Practice Address - Phone:859-258-8530
Practice Address - Fax:859-258-8515
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA599363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95004644Medicaid
KY37903705OtherMEDICAID LAB GROUP
KY4000501OtherMEDICARE LAB GROUP
KY0623910Medicare PIN
KY95004644Medicaid