Provider Demographics
NPI:1831495076
Name:MACHABEE, HEATHER (RN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:MACHABEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MURRLIN DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3427
Mailing Address - Country:US
Mailing Address - Phone:518-475-1745
Mailing Address - Fax:
Practice Address - Street 1:328 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:GLENMONT
Practice Address - State:NY
Practice Address - Zip Code:12077-2908
Practice Address - Country:US
Practice Address - Phone:518-463-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY464708-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse