MEDICARE: HEATHER PARKERSON 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209.023104	IL
2	363LF0000X	Family Nurse Practitioner	71006818B	IN
3	363LF0000X	Family Nurse Practitioner	71006818A	IN
4	163W00000X	Registered Nurse	28184494A	IN

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

General Provider Information

NPI Number	:	1467901025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER PARKERSON FNP

Provider Business Mailing Address
First Line	:	1609 SHERMAN AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-3753
Country	:	US
Telephone Number	:	312-380-2790
Fax Number	:	312-380-2791

Provider Business Practice Location Address
First Line	:	1609 SHERMAN AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-3753
Country	:	US
Telephone Number	:	312-380-2790
Fax Number	:	312-380-2791

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

Provider Enumeration Date	:	09/23/2016
Last Update Date	:	01/13/2026

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Directions to “ HEATHER PARKERSON FNP” Practice Location

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