Provider Demographics
NPI:1811579238
Name:LEWIS, HEATHER NICOLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:SHERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6517 STRAWBANK DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-6509
Mailing Address - Country:US
Mailing Address - Phone:804-370-4936
Mailing Address - Fax:
Practice Address - Street 1:6517 STRAWBANK DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-6509
Practice Address - Country:US
Practice Address - Phone:804-370-4936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001197094163W00000X
VA0024181328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse