Provider Demographics
NPI:1023601465
Name:BROWN, HEATHER JEANNE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JEANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:JEANNE
Other - Last Name:DEROKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1611 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-4708
Mailing Address - Country:US
Mailing Address - Phone:484-347-5005
Mailing Address - Fax:
Practice Address - Street 1:5445 LANARK RD STE 103
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8694
Practice Address - Country:US
Practice Address - Phone:484-526-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily