Heacock, Nathan John Wilson

Heacock, Nathan John Wilson is an individual health care provider with primary practice located at 1800 N California St , Stockton CA 95204-6019. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Heacock, Nathan John Wilson can be contacted via phone (209) 943-2000.

Contact Information

Primary practice address
1800 N California St Stockton CA 95204-6019
Phone: (209) 943-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN95178472 California
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 95001167 California

Profile Details

NPI number 1881155836
LBN Legal business name Heacock, Nathan John Wilson
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2019
Last updated Aug 13th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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