Provider Demographics
NPI:1225803166
Name:HALL JONES, HEATHER RAE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RAE
Last Name:HALL JONES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RAE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:4253 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:CAPE CHARLES
Mailing Address - State:VA
Mailing Address - Zip Code:23310
Mailing Address - Country:US
Mailing Address - Phone:210-848-8460
Mailing Address - Fax:
Practice Address - Street 1:2528 LAS BRISAS DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-4264
Practice Address - Country:US
Practice Address - Phone:757-689-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188742363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health