Individual
MRS. HEATHER NICOLE REESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
227 MEDICAL PARK DR, STE 101, BRIDGEPORT, WV 26330-9038
(681) 342-3500
Mailing address
227 MEDICAL PARK DR, STE 101, BRIDGEPORT, WV 26330-9038
(681) 342-3500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01100
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001835129
BC/BS NUMBER
WV
05
—
0098351000
—
WV
Enumeration date
08/02/2006
Last updated
06/13/2016
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