Individual
MS. MARY MARGARET HEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2055 KIMBALL AVE STE 101, WATERLOO, IA 50702-5047
(319) 272-2112
(319) 272-2107
Mailing address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-7304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000927
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016889
RR MDCR
IA
01
—
IA0106
JOHN DEERE HEALTHCARE
IA
Enumeration date
03/31/2006
Last updated
07/23/2026
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