Basic Information
| Provider Information | |||||||||
| NPI: | 1306802251 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEARD | ||||||||
| FirstName: | CHRISTA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2307 HOMER CLAYTON DR | ||||||||
| Address2: | |||||||||
| City: | GUNTERSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359762205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565718770 | ||||||||
| FaxNumber: | 2565718775 | ||||||||
| Practice Location | |||||||||
| Address1: | 2307 HOMER CLAYTON DR | ||||||||
| Address2: | |||||||||
| City: | GUNTERSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359762205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565718770 | ||||||||
| FaxNumber: | 2565718775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 02/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 1-063542 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.