Doctor Name: | NANCY J HERIOT |
NPI Number: | 1053407148 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP-C |
License Number: | 3024682 |
Business Practice Address: | 411 E Nelson Ave Defuniak Springs, FL - 324337444 |
Business Phone Number: | 8508924791 |
Business Fax Number: | 8508923868 |
Mailing Address: | 411 E Nelson Ave, DEFUNIAK SPRINGS |
State: | FL |
Postal Code: | 324337444 |
Phone Number: | 8508924791 |
Fax Number: | 8508923868 |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3024682 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |