Individual
HEATHER MACLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP / APRN
Contact information
Practice address
620 NW 16TH AVE, GAINESVILLE, FL 32601-4034
(352) 376-1611
Mailing address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 376-1611
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
9219978
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9219978
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00045200
—
FL
05
—
000456200
—
FL
01
—
RTANCV8332
MEDICARE
—
Enumeration date
03/24/2008
Last updated
09/23/2021
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