Healthcare Provider Details

I. General information

NPI: 1659692135
Provider Name (Legal Business Name): HEATHER BLOESSER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S MAIN ST
PECULIAR MO
64078-9603
US

IV. Provider business mailing address

2820 E ROCK HAVEN RD
HARRISONVILLE MO
64701-4417
US

V. Phone/Fax

Practice location:
  • Phone: 816-779-1100
  • Fax: 816-779-1119
Mailing address:
  • Phone: 816-887-0310
  • Fax: 816-887-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7467
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: