Healthcare Provider Details

I. General information

NPI: 1346823531
Provider Name (Legal Business Name): HEATHER BARTLETT APRN -PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6641 KANIKSU ST
BONNERS FERRY ID
83805-7532
US

IV. Provider business mailing address

6641 KANIKSU ST
BONNERS FERRY ID
83805-7532
US

V. Phone/Fax

Practice location:
  • Phone: 208-267-3655
  • Fax: 208-267-3757
Mailing address:
  • Phone: 208-267-3655
  • Fax: 208-267-3757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number68109
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: