=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235178138
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEIDI J STRICKLAND FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 12/18/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 FOOTE AVE
-----------------------------------------------------
City | JAMESTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14701-8204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-487-2880
-----------------------------------------------------
Fax | 716-483-3030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 41
-----------------------------------------------------
City | JAMESTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14702-0041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-487-1124
-----------------------------------------------------
Fax | 716-487-2488
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F330152
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------