Mata, Heather Lynne

Mata, Heather Lynne is an individual health care provider with primary practice located at 3495 S 4Th St , Terre Haute IN 47802-5501. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Mata, Heather Lynne can be contacted via phone (812) 220-4755.

Contact Information

Primary practice address
3495 S 4Th St Terre Haute IN 47802-5501
Phone: (812) 220-4755
Fax: (812) 231-4475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 10001212A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002771 Michigan

Profile Details

NPI number 1518912971
LBN Legal business name Mata, Heather Lynne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Apr 9th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518912971 NPPES
Michigan Other 0852915110 BC PIN
Michigan Other 1010612 BC PIN

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