Healthcare Provider Details

I. General information

NPI: 1265097976
Provider Name (Legal Business Name): REBECCA P HECK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 GAYTON RD
RICHMOND VA
23238-3482
US

IV. Provider business mailing address

11600 GAYTON RD
RICHMOND VA
23238-3482
US

V. Phone/Fax

Practice location:
  • Phone: 804-740-3394
  • Fax:
Mailing address:
  • Phone: 804-740-3394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number0001228594
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: