Individual
HEATHER WARNER MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-6220
(860) 679-4477
(860) 679-4474
Mailing address
55 PEBBLE DIVE, SOUTHINGTON, CT 06489
(860) 620-0335
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
005176
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
005176
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205192689
—
CT
Enumeration date
04/10/2012
Last updated
07/11/2022
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