Individual
HEATHER LACONYA VEAL FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-078798
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100166
—
AL
01
—
1700069887
BC BS OF GEORGIA
GA
01
—
515-45747
BC BS OF AL
AL
05
—
735502860A
—
GA
01
—
P00692162
RAILROAD PROVIDER #
AL
Enumeration date
12/11/2007
Last updated
10/26/2020
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