Provider Demographics
NPI:1366074122
Name:CLARKE, HEATHER LYNNE KIRBY (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE KIRBY
Last Name:CLARKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:KIRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:238 NORTHAMPTON ST
Mailing Address - Street 2:VALLEY MEDICAL GROUP, PC-EASTHAMPTON HEATH CENTER
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027
Mailing Address - Country:US
Mailing Address - Phone:413-529-9300
Mailing Address - Fax:866-644-0870
Practice Address - Street 1:238 NORTHAMPTON ST
Practice Address - Street 2:VALLEY MEDICAL GROUP, PC-EASTHAMPTON HEATH CENTER
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027
Practice Address - Country:US
Practice Address - Phone:413-529-9300
Practice Address - Fax:866-644-0870
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA7409363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant