Provider Demographics
NPI:1356895742
Name:MAYER, HEATHER LYNNE (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE
Last Name:MAYER
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 1:176 LORI CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-6887
Mailing Address - Country:US
Mailing Address - Phone:757-593-0016
Mailing Address - Fax:
Practice Address - Street 1:9 MANHATTAN SQ STE A
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6262
Practice Address - Country:US
Practice Address - Phone:757-838-6335
Practice Address - Fax:757-838-0612
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical