# HEATHER NICOLE MAFFEO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568903391
- **Gender:** F
- **Credential:** PA-C, ATC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2255A2300X | Athletic Trainer | 2000006538 | CT | — |
| 363A00000X | Physician Assistant | 36670 | SC | Yes |
| 363AM0700X | Medical Physician Assistant | 1143416 | SC | — |

## Other

- **Enumeration date:** 03/13/2017
- **Last updated:** 11/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3040PA | — | SC |