Provider Demographics
NPI:1992348221
Name:HEILINGOETTER, CASSANDRA LYNN (PA-C)
Entity type:Individual
Prefix:MISS
First Name:CASSANDRA
Middle Name:LYNN
Last Name:HEILINGOETTER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6145 RED CEDAR DR APT 3G
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-7178
Mailing Address - Country:US
Mailing Address - Phone:630-388-9610
Mailing Address - Fax:
Practice Address - Street 1:501 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1118
Practice Address - Country:US
Practice Address - Phone:336-832-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-09449363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant