Healthcare Provider Details

I. General information

NPI: 1346553575
Provider Name (Legal Business Name): HEATHER RICHARDSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 GLADEVIEW DR
FRIES VA
24330-3936
US

IV. Provider business mailing address

279 GLADEVIEW DR
FRIES VA
24330-3936
US

V. Phone/Fax

Practice location:
  • Phone: 276-233-7864
  • Fax:
Mailing address:
  • Phone: 276-744-2224
  • Fax: 276-236-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024168882
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: