Individual
MARLEA HEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
145 PLEASANT DR, WARREN, PA 16365-3371
(814) 723-8023
(814) 723-8025
Mailing address
145 PLEASANT DR, WARREN, PA 16365-3371
(814) 723-8023
(814) 723-8025
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA063105
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039807220001
—
PA
Enumeration date
10/26/2021
Last updated
07/13/2022
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