Individual
SHARON ANN HEIDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
201 STATE STREET, HAMOT FACULTY SPECIALISTS, ERIE, PA 16550-0000
(814) 877-6000
Mailing address
717 STATE ST, SUITE 16, LL, ERIE, PA 16501-1341
(814) 480-7100
(814) 480-7604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
TP006470B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027128201
UNIVERA
NY
01
—
02644686
NY MEDICAL ASSISTANCE
NY
01
—
1731267
BLUE SHIELD
PA
01
—
P00365443
RR MEDICARE
PA
Enumeration date
07/05/2006
Last updated
05/09/2008
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