Individual
MRS. GABRIELLE HEATWOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
110 WAKEFIELD RD, OAK RIDGE, TN 37830-3721
(423) 377-5216
Mailing address
110 WAKEFIELD RD, OAK RIDGE, TN 37830-3721
(423) 377-5216
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
90779
TN
Other
Enumeration date
11/08/2022
Last updated
11/22/2022
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