Doctor Name: | REBECCA HEATHERLY |
NPI Number: | 1821344763 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | 80366 |
Business Practice Address: | 1501 Georgia Ave Woodbine, GA - 315695504 |
Business Phone Number: | 9125763040 |
Business Fax Number: | 9125763833 |
Mailing Address: | 150 Scranton Connector, BRUNSWICK |
State: | GA |
Postal Code: | 315250540 |
Phone Number: | 9122801462 |
Fax Number: | 9122623036 |
NPI Enumeration Date: | 07/30/2012 |
NPI Last Update Date: | 07/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 80366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |