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General NPI Number Information
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NPI Number | 1720030786
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Entity Type | Individual
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Provider Name | HEATHER D HAHN PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 22347 NORTHWESTERN PIKE
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City | ROMNEY
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State | WV
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Zip | 26757-6343
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Country | US
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Telephone | 304-822-3838
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1737
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City | ROMNEY
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State | WV
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Zip | 26757-4737
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Country | US
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Telephone | 304-822-6614
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Fax | 909-557-1924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 01195
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License Number State | WV
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