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Aydan Luke Heavner

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

4350 Us 421 S, Lillington, NC 27546-6760

PECOS Enrollment

This provider is enrolled in PECOS as AYDAN HEAVNER.

Based on the most recent information from CMS, provider Aydan Luke Heavner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1093420697
Provider Type
Individual
Full Name
Heavner, Aydan Luke
Gender
Male

Sole Proprietor
No
Enumeration Date
1/18/2023
Last Updated
1/17/2024

Contact Information

Practice Location

4350 Us 421 S, Lillington, NC 27546-6760

(910) 893-1210

Unlisted Fax

Mailing Location

924 Clear Creek Cir, Lincolnton, NC 28092-8005

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 001004740 North Carolina
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Aydan Luke Heavner

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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