Individual
NATALIE RAE HEASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12200 WARWICK BLVD STE 410, NEWPORT NEWS, VA 23601
(757) 534-5200
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003243
VA
363AS0400X
Surgical Physician Assistant
0110003243
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110003243
STATE LICENSE
VA
01
—
10063347P
SENTARA
VA
01
—
VAA101591
MEDICARE
—
Enumeration date
04/14/2010
Last updated
07/21/2022
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