Healthcare Provider Details

I. General information

NPI: 1952531576
Provider Name (Legal Business Name): HEATHER L. MCCASLIN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11010 EDINBORO RD
MC KEAN PA
16426-2226
US

IV. Provider business mailing address

11010 EDINBORO RD
MC KEAN PA
16426-2226
US

V. Phone/Fax

Practice location:
  • Phone: 814-273-0486
  • Fax:
Mailing address:
  • Phone: 814-273-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN280892
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: