Healthcare Provider Details

I. General information

NPI: 1184131856
Provider Name (Legal Business Name): HEATHER LYNN LABELLE MSN, CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 RIDGEBROOK RD STE 22
SPARKS MD
21152-9474
US

IV. Provider business mailing address

327 LENAPE TRL
ALLENTOWN PA
18104-8532
US

V. Phone/Fax

Practice location:
  • Phone: 301-928-5012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018320
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: