Individual
HEIDI MECUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 MARKET ST, 2ND FLOOR, LEWISBURG, PA 17837-3002
(570) 524-0900
Mailing address
838 FOURTH ST, JERSEY SHORE, PA 17740-7030
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN262348
PA
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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