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General NPI Number Information
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NPI Number | 1285883306
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Entity Type | Individual
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Provider Name | HEATHER D ELEY NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2800 GODWIN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434-8038
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Country | US
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Telephone | 757-923-9604
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Fax | 757-539-6237
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Provider Business Mailing Address
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Address Line | 2008 PATRICK DR
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City | SUFFOLK
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State | VA
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Zip | 23435-1278
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | VN 232939
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024179500
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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