Individual
GILLIAN VAUGHAN HEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 E 3RD ST, DELTA, CO 81416-2815
(970) 874-7681
Mailing address
12484 WOODBURY HWY, GREENVILLE, GA 30222-3827
(770) 823-3879
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9715
GA
363A00000X
Physician Assistant
PA.0008918
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000240652
—
CO
Enumeration date
04/06/2020
Last updated
06/05/2026
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