Basic Information
| Provider Information | |||||||||
| NPI: | 1669994190 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEATON | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 214 KING STREET | ||||||||
| Address2: | |||||||||
| City: | OGDENSBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153933600 | ||||||||
| FaxNumber: | 3153937250 | ||||||||
| Practice Location | |||||||||
| Address1: | 214 KING STREET | ||||||||
| Address2: | |||||||||
| City: | OGDENSBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153933600 | ||||||||
| FaxNumber: | 3153937250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 341920 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.