Provider Demographics
NPI:1538252788
Name:CONDON, HEATHER ANNE III (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANNE
Last Name:CONDON
Suffix:III
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:8428 BLAKISTON LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2104
Mailing Address - Country:US
Mailing Address - Phone:703-360-1887
Mailing Address - Fax:
Practice Address - Street 1:2616 SHERWOOD HALL LN
Practice Address - Street 2:SUITE 408
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3100
Practice Address - Country:US
Practice Address - Phone:703-360-8688
Practice Address - Fax:703-780-7019
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0110001342363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant