Provider Demographics
NPI:1053578864
Name:TOMPKINS HANSBARGER, HEATHER (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:TOMPKINS HANSBARGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 JACKSONVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4807
Mailing Address - Country:US
Mailing Address - Phone:215-957-1100
Mailing Address - Fax:215-957-1111
Practice Address - Street 1:882 JACKSONVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-4807
Practice Address - Country:US
Practice Address - Phone:215-957-1100
Practice Address - Fax:215-957-1111
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002511L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical