Provider Demographics
NPI:1275850927
Name:VAN HECKE, ERIC RYAN (PA-C, MPAS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:RYAN
Last Name:VAN HECKE
Suffix:
Gender:M
Credentials:PA-C, MPAS
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Mailing Address - Street 1:4600 LAKE ROAD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1845
Mailing Address - Country:US
Mailing Address - Phone:763-588-7099
Mailing Address - Fax:763-522-2222
Practice Address - Street 1:4600 LAKE ROAD AVE STE 301
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-1845
Practice Address - Country:US
Practice Address - Phone:763-588-7099
Practice Address - Fax:763-522-2222
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN10627363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical