Provider Demographics
NPI:1275888323
Name:CONWAY, HEATHER RENEE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:CONWAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18562 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WV
Mailing Address - Zip Code:25033
Mailing Address - Country:US
Mailing Address - Phone:304-937-7070
Mailing Address - Fax:304-937-7070
Practice Address - Street 1:18562 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WV
Practice Address - Zip Code:25033
Practice Address - Country:US
Practice Address - Phone:304-937-7070
Practice Address - Fax:304-937-7070
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV73342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily