Basic Information
| Provider Information | |||||||||
| NPI: | 1568117802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HECKMAN | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | THERESE | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 FIREHOUSE RD | ||||||||
| Address2: | |||||||||
| City: | PALMERTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180713616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4847984476 | ||||||||
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| Practice Location | |||||||||
| Address1: | 179 INDEPENDENCE RD | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183019207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704262700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2022 | ||||||||
| LastUpdateDate: | 09/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | SP024374 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.