Provider Demographics
NPI:1063398188
Name:HERON, VENESHA K
Entity type:Individual
Prefix:
First Name:VENESHA
Middle Name:K
Last Name:HERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CANTERBURY ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-1822
Mailing Address - Country:US
Mailing Address - Phone:860-484-3262
Mailing Address - Fax:
Practice Address - Street 1:84 CANTERBURY ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-1822
Practice Address - Country:US
Practice Address - Phone:860-484-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker
No175M00000XOther Service ProvidersMidwife, Lay