Healthcare Provider Details

I. General information

NPI: 1487217063
Provider Name (Legal Business Name): HEATHER M WEEKS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S BABCOCK ST
MELBOURNE FL
32901-1459
US

IV. Provider business mailing address

408 LAKE HOLLOW RD
PINEY FLATS TN
37686-3237
US

V. Phone/Fax

Practice location:
  • Phone: 321-951-1010
  • Fax: 321-952-4038
Mailing address:
  • Phone: 423-212-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11001802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: