Healthcare Provider Details

I. General information

NPI: 1073194643
Provider Name (Legal Business Name): HEATHER ANNE YEAKEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1872 ST LUKES BLVD
EASTON PA
18045-5669
US

IV. Provider business mailing address

3445 HIGH POINT BLVD STE 400
BETHLEHEM PA
18017-7817
US

V. Phone/Fax

Practice location:
  • Phone: 215-991-8100
  • Fax:
Mailing address:
  • Phone: 610-866-5555
  • Fax: 610-866-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMT225167
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: