Provider Demographics
NPI:1417725805
Name:FRISBY, HEATHER COLLEEN (CPNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:COLLEEN
Last Name:FRISBY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:COLLEEN
Other - Last Name:MONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3173 CHANNEL BASS LN
Mailing Address - Street 2:
Mailing Address - City:MACHIPONGO
Mailing Address - State:VA
Mailing Address - Zip Code:23405-2217
Mailing Address - Country:US
Mailing Address - Phone:757-710-3161
Mailing Address - Fax:
Practice Address - Street 1:20280 MARKET ST
Practice Address - Street 2:
Practice Address - City:ONANCOCK
Practice Address - State:VA
Practice Address - Zip Code:23417-1331
Practice Address - Country:US
Practice Address - Phone:757-414-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188988363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics