Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nathan John Wilson Heacock, CRNA

Individual provider Registered Nurse · NPI 1881155836

Nathan John Wilson Heacock, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Stockton, California. Qualified in 2019, 7 years ago. Practices with El Dorado Anesthesia Medical Group, a 16-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1800 N California St
Stockton, CA 95204-6019
Phone: (209) 943-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 95001167 (CA)
Registered Nurse Taxonomy 163W00000X · Licence RN95178472 (CA)

Record details

NPI number1881155836
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMarch 30, 2019
Last updated in NPPESAugust 13, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice El Dorado Anesthesia Medical Group — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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