Provider Demographics
NPI:1841220159
Name:ROMANO, HEATHER DEE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DEE
Last Name:ROMANO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 11TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-3608
Mailing Address - Country:US
Mailing Address - Phone:386-362-0820
Mailing Address - Fax:386-362-0821
Practice Address - Street 1:1116 11TH ST SW
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-3608
Practice Address - Country:US
Practice Address - Phone:386-362-0820
Practice Address - Fax:386-362-0821
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL352338-2111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily