Individual
CHRISTINE L HERITAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NMNP
Contact information
Practice address
353 DEADMOND FERRY RD, SPRINGFIELD, OR 97477-9406
(541) 222-7750
Mailing address
1115 SE 164TH AVE, DEPT 358, VANCOUVER, WA 98683-9324
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
089006318N5
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080205
—
OR
Enumeration date
06/02/2006
Last updated
03/09/2016
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