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Individual
HEATHER NICOLE MAFFEO
Active
Individual
HEATHER NICOLE MAFFEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2000006538
CT
363A00000X
Physician Assistant
Primary
36670
SC
363AM0700X
Medical Physician Assistant
1143416
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3040PA
—
SC
Enumeration date
03/13/2017
Last updated
11/05/2020
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