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General NPI Number Information
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NPI Number | 1780340422
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Entity Type | Individual
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Provider Name | MELISSA HEITZENRATER PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 110 N MAIN ST FL 3
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City | GREENVILLE
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State | PA
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Zip | 16125-1726
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Country | US
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Telephone | 724-589-4318
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Fax | 724-588-1808
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Provider Business Mailing Address
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Address Line | 7406 CHESTNUT WAY
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City | GIBSONIA
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State | PA
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Zip | 15044-6929
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Country | US
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Telephone | 724-759-4313
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA062358
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License Number State | PA
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