Provider Demographics
NPI:1932528189
Name:RATHOD, HEENA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:HEENA
Middle Name:
Last Name:RATHOD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1242
Mailing Address - Country:US
Mailing Address - Phone:610-372-9222
Mailing Address - Fax:610-372-0232
Practice Address - Street 1:655 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1242
Practice Address - Country:US
Practice Address - Phone:610-372-9222
Practice Address - Fax:610-372-0232
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013119363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics