Provider Demographics
NPI:1598424418
Name:HEETER, SARAH A
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:HEETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 SPRINGER WAY APT 614
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8332
Mailing Address - Country:US
Mailing Address - Phone:312-215-5733
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLZ # 7B
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9355
Practice Address - Fax:810-262-6341
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant