Provider Demographics
NPI:1194256065
Name:STEELE, HEATHER L (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:STEELE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1306 CONCOURSE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1027
Mailing Address - Country:US
Mailing Address - Phone:443-351-3376
Mailing Address - Fax:410-431-8935
Practice Address - Street 1:231 NAJOLES RD STE 300
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2659
Practice Address - Country:US
Practice Address - Phone:443-351-3376
Practice Address - Fax:443-494-2303
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC06420363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant