Provider Demographics
NPI:1356063358
Name:HEARD, JOHN HOWARD JR (NP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HOWARD
Last Name:HEARD
Suffix:JR
Gender:M
Credentials:NP
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 1315
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:VA
Mailing Address - Zip Code:23181-1315
Mailing Address - Country:US
Mailing Address - Phone:804-218-2274
Mailing Address - Fax:
Practice Address - Street 1:827 LEE STREET
Practice Address - Street 2:#1315
Practice Address - City:WEST POINT
Practice Address - State:VA
Practice Address - Zip Code:23181
Practice Address - Country:US
Practice Address - Phone:804-218-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care