Healthcare Provider Details

I. General information

NPI: 1821781618
Provider Name (Legal Business Name): ELIZABETH ANN HEATON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

905 PITTSBURGH ST
SCOTTDALE PA
15683-1654
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-2000
  • Fax:
Mailing address:
  • Phone: 814-483-1093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: