Individual
TAVITHIA HEIDELBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
PO BOX 261, BRANDON, MS 39043-0261
(601) 353-8486
Mailing address
PO BOX 261, BRANDON, MS 39043-0261
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902245
MS
Other
Enumeration date
01/28/2018
Last updated
03/02/2026
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