Individual
MAKAYLA ANN HEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
298 TRICORN RD, DANVILLE, WV 25053-7148
(304) 369-1385
Mailing address
181 FOXVIEW LN, BOB WHITE, WV 25028-9010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
36249
WV
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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