Healthcare Provider Details

I. General information

NPI: 1972079853
Provider Name (Legal Business Name): MISTI HESTON APRN, FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISTI FISHER

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 S RUSH AVE
RUSH SPRINGS OK
73082-3125
US

IV. Provider business mailing address

2100 W IOWA AVE STE A
CHICKASHA OK
73018-2736
US

V. Phone/Fax

Practice location:
  • Phone: 580-476-2527
  • Fax: 580-476-3707
Mailing address:
  • Phone: 405-224-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number75310
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: