Provider Demographics
NPI:1164411708
Name:STALKER, HEATHER JEAN (MSC, CGC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:JEAN
Last Name:STALKER
Suffix:
Gender:F
Credentials:MSC, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 100296 1700 SW 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-7703
Mailing Address - Country:US
Mailing Address - Phone:352-294-5042
Mailing Address - Fax:352-294-8058
Practice Address - Street 1:DIVISION OF PEDIATRIC GENETICS, UNIVERSITY OF FLORIDA
Practice Address - Street 2:BOX 100296
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0296
Practice Address - Country:US
Practice Address - Phone:352-392-8032
Practice Address - Fax:352-392-3051
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
FL41170300000X
CT298170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS