Provider Demographics
NPI:1700894045
Name:HEARD, ROMAINE H (CRNP)
Entity Type:Individual
Prefix:
First Name:ROMAINE
Middle Name:H
Last Name:HEARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ROMAINE
Other - Middle Name:H
Other - Last Name:MACKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:256-492-0131
Mailing Address - Fax:
Practice Address - Street 1:4055 AL HIGHWAY 9
Practice Address - Street 2:SUITE F
Practice Address - City:CEDAR BLUFF
Practice Address - State:AL
Practice Address - Zip Code:35959-5099
Practice Address - Country:US
Practice Address - Phone:256-779-6057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1059304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL138679 (WATTS)Medicaid
AL630401166Medicaid
AL630408116Medicaid
AL511-27374 (CHEROKEE)OtherBLUE CROSS
AL630411116Medicaid
AL138576 (CHEROKEE)Medicaid
AL102I50387 (WATTS)Medicare PIN
AL138576 (CHEROKEE)Medicaid
AL511-27374 (CHEROKEE)OtherBLUE CROSS