Provider Demographics
NPI:1770054389
Name:CULLIGAN, HEATHER LAYNE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LAYNE
Last Name:CULLIGAN
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:337-991-9276
Mailing Address - Fax:337-943-0846
Practice Address - Street 1:1510 FOREST AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1517
Practice Address - Country:US
Practice Address - Phone:334-834-6422
Practice Address - Fax:334-264-5129
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2021-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-138851363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner