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General NPI Number Information
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NPI Number | 1801490883
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Entity Type | Individual
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Provider Name | HEATHER ANNE MCQUEEN RNFA, CNOR
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 2209 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-5930
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Country | US
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Telephone | 315-801-8225
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Fax |
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Provider Business Mailing Address
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Address Line | 5502 COREY CT
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City | MARCY
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State | NY
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Zip | 13403-3411
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Country | US
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Telephone | 315-794-1277
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 617446-1
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License Number State | NY
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