Healthcare Provider Details

I. General information

NPI: 1225502297
Provider Name (Legal Business Name): HEATHER STRATTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 E BRADFORD PKWY
SPRINGFIELD MO
65804-6563
US

IV. Provider business mailing address

315 E CLEVELAND AVE
MONETT MO
65708-1704
US

V. Phone/Fax

Practice location:
  • Phone: 417-881-4994
  • Fax: 417-881-4998
Mailing address:
  • Phone: 417-235-0196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2018040404
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: