Provider Demographics
NPI:1265111363
Name:MAYARD, HEATHER RENEE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:MAYARD
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1811
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70511-1811
Mailing Address - Country:US
Mailing Address - Phone:337-385-2522
Mailing Address - Fax:337-385-2523
Practice Address - Street 1:1828 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-3142
Practice Address - Country:US
Practice Address - Phone:337-385-2522
Practice Address - Fax:337-385-2523
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA231775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6A0076OtherMEDICARE