Provider Demographics
NPI:1073572897
Name:AULICK, HEATHER R (CFNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:AULICK
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 15TH ST
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701
Mailing Address - Country:US
Mailing Address - Phone:304-691-8500
Mailing Address - Fax:304-691-8510
Practice Address - Street 1:1249 15TH ST
Practice Address - Street 2:SUITE 4000
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701
Practice Address - Country:US
Practice Address - Phone:304-691-8500
Practice Address - Fax:304-691-8510
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7101104000Medicaid
OH2301315Medicaid
KY78010378Medicaid
WVNP09732Medicare ID - Type Unspecified
OH2301315Medicaid