Provider Demographics
NPI:1386978195
Name:SCHOPPOL, HEATHER (RN)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:SCHOPPOL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE B.
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1178
Mailing Address - Country:US
Mailing Address - Phone:505-884-4464
Mailing Address - Fax:505-884-0054
Practice Address - Street 1:4055 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE B.
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1178
Practice Address - Country:US
Practice Address - Phone:505-884-4464
Practice Address - Fax:505-884-0054
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR50429163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult