Healthcare Provider Details

I. General information

NPI: 1730416819
Provider Name (Legal Business Name): HEATHER R MCKEEVER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER R HOBAUGH

II. Dates (important events)

Enumeration Date: 11/10/2009
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD STE 304
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

2570 HAYMAKER RD STE 304
MONROEVILLE PA
15146-3513
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-3070
  • Fax: 412-858-3076
Mailing address:
  • Phone: 412-858-3070
  • Fax: 412-858-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA054206
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA054206
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: