Provider Demographics
NPI:1851045660
Name:OLIVETT, HEATHER (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:OLIVETT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476-1108
Mailing Address - Country:US
Mailing Address - Phone:802-922-8107
Mailing Address - Fax:
Practice Address - Street 1:30 NORTH AVE
Practice Address - Street 2:
Practice Address - City:RICHFORD
Practice Address - State:VT
Practice Address - Zip Code:05476-1108
Practice Address - Country:US
Practice Address - Phone:802-922-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0135162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily