Provider Demographics
NPI:1982357935
Name:CARLEY, HEIDI ANN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN
Last Name:CARLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05363
Mailing Address - Country:US
Mailing Address - Phone:802-464-8333
Mailing Address - Fax:802-464-8313
Practice Address - Street 1:6 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:VT
Practice Address - Zip Code:05363
Practice Address - Country:US
Practice Address - Phone:802-464-8333
Practice Address - Fax:802-464-8313
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0130077163WA2000X, 163WC0400X, 163WC1600X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development