Provider Demographics
NPI:1316219421
Name:PICKERING, HERA S (PRIVATE CAREGIVER)
Entity Type:Individual
Prefix:
First Name:HERA
Middle Name:S
Last Name:PICKERING
Suffix:
Gender:F
Credentials:PRIVATE CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 FORREST RD
Mailing Address - Street 2:
Mailing Address - City:FALL BRANCH
Mailing Address - State:TN
Mailing Address - Zip Code:37656-1750
Mailing Address - Country:US
Mailing Address - Phone:423-348-6285
Mailing Address - Fax:
Practice Address - Street 1:124 FORREST RD
Practice Address - Street 2:
Practice Address - City:FALL BRANCH
Practice Address - State:TN
Practice Address - Zip Code:37656-1750
Practice Address - Country:US
Practice Address - Phone:423-348-6285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider