Individual
BETHANY KATE HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
4380 DONCASTER DR, ELLICOTT CITY, MD 21043-6782
(443) 220-7546
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C05554
MD
Other
Enumeration date
09/17/2014
Last updated
04/16/2018
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