Provider Demographics
NPI:1528231123
Name:PICKETT, HEATHER CHRISTINE (WH NP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:WH NP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:CHRISTINE
Other - Last Name:MATOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WH NP
Mailing Address - Street 1:125 HOSPITAL CENTER BLVD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-6202
Mailing Address - Country:US
Mailing Address - Phone:540-720-7340
Mailing Address - Fax:540-720-7341
Practice Address - Street 1:125 HOSPITAL CENTER BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6202
Practice Address - Country:US
Practice Address - Phone:540-720-7340
Practice Address - Fax:540-720-7341
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51263163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory