Healthcare Provider Details

I. General information

NPI: 1689794810
Provider Name (Legal Business Name): DR. HEATHER NEIGHBORS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER NEIGHBORS

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 FIRST COAST HWY
FERNANDINA BEACH FL
32034-5597
US

IV. Provider business mailing address

1795 JACKSON CT
FERNANDINA BEACH FL
32034-5616
US

V. Phone/Fax

Practice location:
  • Phone: 904-491-9803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS60668
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number239
License Number StateVI
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202205352
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: