Provider Demographics
NPI:1265180020
Name:HOUSTON, HEIDI C (MSN-FNP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:C
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 GUNSTON CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8100
Mailing Address - Country:US
Mailing Address - Phone:757-753-1692
Mailing Address - Fax:
Practice Address - Street 1:1408 GUNSTON CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-8100
Practice Address - Country:US
Practice Address - Phone:757-753-1692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024183795OtherPROFESSIONAL LICENSE NUMBER