MEDICARE: ERICA J HEAGY FNP

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	200550015NP	OR

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

General Provider Information

NPI Number	:	1134218720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA J HEAGY FNP

Provider Business Mailing Address
First Line	:	3851 PIPER ST STE U466
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-6905
Country	:	US
Telephone Number	:	907-569-1333
Fax Number	:	907-569-1433

Provider Business Practice Location Address
First Line	:	3851 PIPER ST STE U466
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-6905
Country	:	US
Telephone Number	:	907-569-1333
Fax Number	:	907-569-1433

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	02/09/2023

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Directions to “ ERICA J HEAGY FNP” Practice Location

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