Provider Demographics
NPI:1689289464
Name:SILVERII, HEATHER PHILLIPS (FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:PHILLIPS
Last Name:SILVERII
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 LAKELAND DR APT 18B
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9790
Mailing Address - Country:US
Mailing Address - Phone:601-757-6751
Mailing Address - Fax:
Practice Address - Street 1:501 AVALON WAY STE C
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-7500
Practice Address - Country:US
Practice Address - Phone:601-992-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner