Provider Demographics
NPI:1982243614
Name:HECKLER, KAYTLIN (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYTLIN
Middle Name:
Last Name:HECKLER
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 1:403 MATTY DR
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-3710
Mailing Address - Country:US
Mailing Address - Phone:724-470-7701
Mailing Address - Fax:
Practice Address - Street 1:201 MARY HIGGINSON LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2658
Practice Address - Country:US
Practice Address - Phone:724-430-5940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061280363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical