Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | SP017817 | PA |
NPI | 1023527090 |
---|---|
Provider Name | Heather Mary Vetter |
First Address | Langhorne, PA 19053-1544 |
Second Address | Langhorne, PA 19053-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 21/09/2017 |