Stacy Heckard, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP019622 Issued in PA

Practice address

410 E. Penn Ave
Suite 101
Robesonia, PA 19551

Phone

(484) 987-3456

Fax

(610) 693-4574

NPI assigned

Jun 9, 2018

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1497248934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E. PENN AVE",
            "address_2": "SUITE 101",
            "city": "ROBESONIA",
            "state": "PA",
            "postal_code": "19551",
            "telephone_number": "484-987-3456",
            "fax_number": "610-693-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E. PENN AVE",
            "address_2": "SUITE 101",
            "city": "ROBESONIA",
            "state": "PA",
            "postal_code": "19551",
            "telephone_number": "484-987-3456",
            "fax_number": "610-693-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKARD",
        "first_name": "STACY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-09",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019622",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN624672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Kay George, PTA
• Samantha Gogets, MPH, RDN, LDN
• Mark Taylor Grandinetti, PT, DPT
• Vanessa Lynn Hagen, L.P.C.
• Kimberly Alicia Haught, PTA
• Christine Rochelle Hess, PMHNP-BC
• Eric John Hoffmaster, PTA
• Alyssa Hottenstein, PTA
• Eric P Jacobi, DDS
• Karen Elizabeth Keenan, PT

• Family Nurse Practitioner in Robesonia, PA
• Providers in Robesonia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.