Provider Demographics
NPI:1346553575
Name:RICHARDSON, HEATHER (FNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 GLADEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FRIES
Mailing Address - State:VA
Mailing Address - Zip Code:24330-3936
Mailing Address - Country:US
Mailing Address - Phone:276-744-2224
Mailing Address - Fax:276-236-8780
Practice Address - Street 1:279 GLADEVIEW DR
Practice Address - Street 2:
Practice Address - City:FRIES
Practice Address - State:VA
Practice Address - Zip Code:24330-3936
Practice Address - Country:US
Practice Address - Phone:276-233-7864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily