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NPI Code Detail

MEDICARE: HEATHER D ELEY NP

MEDICARE: HEATHER D ELEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerSP034473PA
2363LG0600XGerontology Nurse Practitioner0024179500VA

General Provider Information

NPI Number : 1285883306
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER D ELEY NP
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5516
Fax Number :
Provider Business Practice Location Address
First Line : 1906 BELLEVIEW AVE SE
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1838
Country : US
Telephone Number : 540-981-7000
Fax Number : 540-981-8429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2008
Last Update Date : 06/02/2026

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