Healthcare Provider Details

I. General information

NPI: 1902283526
Provider Name (Legal Business Name): HEATHER LEIGH CUMMINGS PA-C, SA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 ROEHAMPTON VALE
VIRGINIA BEACH VA
23452-6158
US

IV. Provider business mailing address

1005 ROEHAMPTON VALE
VIRGINIA BEACH VA
23452-6158
US

V. Phone/Fax

Practice location:
  • Phone: 757-408-4313
  • Fax:
Mailing address:
  • Phone: 757-408-4313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110-007057
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: