| Doctor Name: | MS. HEATHER J EARL |
| NPI Number: | 1003171323 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | |
| Business Practice Address: | 527 Medical Park Dr Suite 401 Bridgeport, WV - 263309008 |
| Business Phone Number: | 6813423500 |
| Business Fax Number: | 6813423561 |
| Mailing Address: | P O Box 780, MORGANTOWN |
| State: | WV |
| Postal Code: | 265070780 |
| Phone Number: | 3042857101 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2012 |
| NPI Last Update Date: | 09/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |