Individual
HEATHER STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1743 WATSON BLVD, SUITE A, WARNER ROBINS, GA 31093-3622
(478) 328-9690
(478) 328-9692
Mailing address
1743 WATSON BLVD, SUITE A, WARNER ROBINS, GA 31093-3622
(478) 328-9690
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN149564
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0614256
NP CERTIFICATION NUMBER
GA
01
—
RN149564
NURSE PRACTIONER NUMBER
GA
Enumeration date
06/06/2014
Last updated
06/06/2014
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