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1790802809

NPI Code Detail

MEDICARE: MRS. HEATHER DEANN SPOON APN

MEDICARE: MRS. HEATHER DEANN SPOON APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A002985	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790802809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER DEANN SPOON APN

Provider Business Mailing Address
First Line	:	PO BOX 497
Second Line	:
City	:	AUGUSTA
State	:	AR
Zip	:	72006-0497
Country	:	US
Telephone Number	:	870-347-2534
Fax Number	:	870-301-2092

Provider Business Practice Location Address
First Line	:	615 N MAIN ST
Second Line	:
City	:	BRINKLEY
State	:	AR
Zip	:	72021-2507
Country	:	US
Telephone Number	:	870-734-1150
Fax Number	:	870-734-1179

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/03/2025

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Directions to “ MRS. HEATHER DEANN SPOON APN” Practice Location

Language	Start Address	Practice Location

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