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Individual

HEATHER C HUCKABY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
203 ALLENDALE DR, PORT ALLEN, LA 70767-3219
(225) 389-1311
(225) 389-1330
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-1310

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
207321
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
207321
LOUISIANA STATE BOARD OF NURSING
LA
Enumeration date
07/22/2019
Last updated
07/22/2019
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