MEDICARE: MS. HEATHER WILLS P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.200764	LA

General Provider Information

NPI Number	:	1942603592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER WILLS P.A.

Provider Business Mailing Address
First Line	:	200 W ESPLANADE AVE STE 500
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-2475
Country	:	US
Telephone Number	:	504-412-1705
Fax Number	:	504-412-1702

Provider Business Practice Location Address
First Line	:	200 W ESPLANADE AVE STE 500
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-2475
Country	:	US
Telephone Number	:	504-412-1705
Fax Number	:	504-412-1702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	01/22/2026

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