Provider Demographics
NPI:1548685787
Name:DUNCAN, HEATHER L (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:DUNCAN
Suffix:
Gender:
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:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-0598
Mailing Address - Country:US
Mailing Address - Phone:508-905-2800
Mailing Address - Fax:
Practice Address - Street 1:49 HARRY KEMP WAY
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1618
Practice Address - Country:US
Practice Address - Phone:508-487-9395
Practice Address - Fax:508-487-3285
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-004989363A00000X
MAPA5650363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110121748AMedicaid