Provider Demographics
NPI:1497277149
Name:NEWHARD, HEATHER SIOBHAN (CRNP-F)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:SIOBHAN
Last Name:NEWHARD
Suffix:
Gender:F
Credentials:CRNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 DEFENSE HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2469
Mailing Address - Country:US
Mailing Address - Phone:410-451-9091
Mailing Address - Fax:410-451-9094
Practice Address - Street 1:2191 DEFENSE HWY STE 201
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2469
Practice Address - Country:US
Practice Address - Phone:410-451-9091
Practice Address - Fax:410-451-9094
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR194913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine