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NPI Code Detail

MEDICARE: HEATHER LAUREN TERPSTRA NP-C

MEDICARE:   HEATHER LAUREN TERPSTRA  NP-C
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
1363LF0000XFamily Nurse Practitioner4704318673MI

General Provider Information

NPI Number : 1588211452
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LAUREN TERPSTRA NP-C
Provider Business Mailing Address
First Line : PO BOX 1847
Second Line :
City : MUSKEGON
State : MI
Zip : 49443-1847
Country : US
Telephone Number : 231-672-2119
Fax Number :
Provider Business Practice Location Address
First Line : 6401 PRAIRIE ST STE 2100
Second Line :
City : NORTON SHORES
State : MI
Zip : 49444-7842
Country : US
Telephone Number : 231-727-7939
Fax Number : 231-727-7935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2019
Last Update Date : 12/06/2021

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Directions to “ HEATHER LAUREN TERPSTRA NP-C” Practice Location

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