Individual
HEIDI MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
169 MARTIN AVE, EPHRATA, PA 17522-1724
(610) 738-6420
Mailing address
3471 HORSESHOE PIKE, HONEY BROOK, PA 19344-8652
(610) 741-9593
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA004188
PA
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
26360536
PA
Other
Enumeration date
12/20/2015
Last updated
07/21/2022
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