Provider Demographics
NPI:1306151196
Name:RECKART, HEATHER LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:RECKART
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N PRICE ST
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1120
Mailing Address - Country:US
Mailing Address - Phone:304-329-3500
Mailing Address - Fax:304-329-2088
Practice Address - Street 1:110 N PRICE ST
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1120
Practice Address - Country:US
Practice Address - Phone:304-329-3500
Practice Address - Fax:304-329-2088
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV68877363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner