Individual
HEATHER RENEE BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6 HICKOK ST, CHRISTIANSBURG, VA 24073-3524
(540) 382-6148
Mailing address
6 HICKOK ST, CHRISTIANSBURG, VA 24073-3524
(540) 382-6148
(540) 382-4191
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001224260
VA
363LF0000X
Family Nurse Practitioner
Primary
0024172857
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992181226
—
VA
01
—
P01563271
RAILROAD MEDICARE
—
Enumeration date
08/10/2015
Last updated
10/21/2021
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