Individual
MRS. ELIZABETH ANNE HEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
501 HOWARD AVE STE F3, ALTOONA, PA 16601-4818
(814) 946-9150
(814) 946-1397
Mailing address
501 HOWARD AVE, STE E1, ALTOONA, PA 16601-4817
(814) 946-9150
(814) 946-1397
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA052176
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA052176
STATE LICENSE NUMBER
PA
Enumeration date
03/06/2007
Last updated
04/30/2020
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