Provider Demographics
NPI:1912908294
Name:MORPHY, HEATHER ANNE (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:MORPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 BENTLEY RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-5760
Mailing Address - Country:US
Mailing Address - Phone:717-333-4478
Mailing Address - Fax:717-898-9205
Practice Address - Street 1:EVERETT-NORTH CLINIC
Practice Address - Street 2:1424 BROADWAY
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201
Practice Address - Country:US
Practice Address - Phone:425-789-2000
Practice Address - Fax:425-789-2096
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066205L207Q00000X
HIMD-23568207Q00000X
ORMD214868207Q00000X
WAMD61333641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD615502200Medicaid
MD01-06724OtherUHC PROVIDER NUMBER
MD2534837OtherAETNA CAPITATED
MD8125496OtherMAMSI PRIMARY CARE
MD021371OtherJHHC PROVIDER NUMBER
MDP16341OtherCAREFIRST MPOS
MD610436-02OtherCAREFIRST MD RENDERING
MD7605-0066OtherCAREFIRST BLUECHOICE
MDD0054890OtherMHIP PROVIDER ID
MD2125496OtherMAMSI SPECIALIST
MD7082015OtherAETNA FEE FOR SERVICE
MD9102198OtherCIGNA PIN
226LI869Medicare ID - Type Unspecified
MD021371OtherJHHC PROVIDER NUMBER