Provider Demographics
NPI:1003395559
Name:CONNER, MARY HEATH (DNP, PMHNP)
Entity type:Individual
Prefix:DR
First Name:MARY HEATH
Middle Name:
Last Name:CONNER
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Gender:F
Credentials:DNP, PMHNP
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Mailing Address - Street 1:1869 GREENWOOD RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-2819
Mailing Address - Country:US
Mailing Address - Phone:757-453-1256
Mailing Address - Fax:319-359-3813
Practice Address - Street 1:2624 SOUTHERN BLVD STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7433
Practice Address - Country:US
Practice Address - Phone:757-453-1256
Practice Address - Fax:319-359-3813
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024192636363LP0808X
NC5010822363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health