Provider Demographics
NPI:1174074074
Name:HERETH, ANNA CATHERINE (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:CATHERINE
Last Name:HERETH
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1722
Mailing Address - Country:US
Mailing Address - Phone:412-225-4910
Mailing Address - Fax:
Practice Address - Street 1:705 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1722
Practice Address - Country:US
Practice Address - Phone:412-225-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.005998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant