Healthcare Provider Details

I. General information

NPI: 1235129974
Provider Name (Legal Business Name): HEATHER A CONNER-MERZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 EAST OREGON RROAD NEUROLOGY & STROKE ASSOCIATES
LITITZ PA
17543-9202
US

IV. Provider business mailing address

640 EAST OREGON RROAD NEUROLOGY & STROKE ASSOCIATES
LITITZ PA
17543-9202
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-8773
  • Fax: 717-569-8187
Mailing address:
  • Phone: 717-569-8773
  • Fax: 717-569-8187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMD051676
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA051676
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: