Individual
MRS. HEATHER ANN WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2888
(574) 364-2544
Mailing address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009429A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031799
—
IN
Enumeration date
07/01/2019
Last updated
01/22/2024
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