Healthcare Provider Details

I. General information

NPI: 1205140605
Provider Name (Legal Business Name): HEATHER M. GIGON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13855 COURTHOUSE RD
DINWIDDIE VA
23841-2254
US

IV. Provider business mailing address

13855 COURTHOUSE RD
DINWIDDIE VA
23841-2254
US

V. Phone/Fax

Practice location:
  • Phone: 804-469-3731
  • Fax:
Mailing address:
  • Phone: 804-469-3731
  • Fax: 434-696-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number336381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: