| Doctor Name: | BONITA HEYDT |
| NPI Number: | 1255447058 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | VP006088B |
| Business Practice Address: | 3407 N 5th Street Hwy Reading, PA - 196052428 |
| Business Phone Number: | 6102088800 |
| Business Fax Number: | 6108981336 |
| Mailing Address: | 2500 Bernville Rd, READING |
| State: | PA |
| Postal Code: | 196059453 |
| Phone Number: | 6102088800 |
| Fax Number: | 6108981336 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | VP006088B |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |