| Doctor Name: | HEATHER MAY SOUTHWICK |
| NPI Number: | 1750756557 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, AG-ACNP |
| License Number: | RN1037248 |
| Business Practice Address: | 4330 Estate Dr Huntingtown, MD - 206399733 |
| Business Phone Number: | 4107033284 |
| Business Fax Number: | |
| Mailing Address: | 4330 Estate Dr, HUNTINGTOWN |
| State: | MD |
| Postal Code: | 206399733 |
| Phone Number: | 4107033284 |
| Fax Number: | |
| NPI Enumeration Date: | 12/04/2015 |
| NPI Last Update Date: | 12/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | RN1037248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |