Provider Demographics
NPI:1083424949
Name:BRAHAM, HEATHER RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:BRAHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RENEE
Other - Last Name:ENGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:274 SPRING WATER LN
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:WV
Mailing Address - Zip Code:26802-8655
Mailing Address - Country:US
Mailing Address - Phone:304-668-9733
Mailing Address - Fax:
Practice Address - Street 1:274 SPRING WATER LN
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:WV
Practice Address - Zip Code:26802-8655
Practice Address - Country:US
Practice Address - Phone:304-668-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV121696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine