Individual
CLARE ANN CODDINGTON HECKATHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005183A
IN
363A00000X
Physician Assistant
13867
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100187125
—
WI
Enumeration date
10/01/2021
Last updated
08/03/2026
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