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NPI Code Detail

MEDICARE: HEATHER BALLANTYNE APRN, FNP-C

MEDICARE: HEATHER BALLANTYNE APRN, FNP-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 Practitioner819914NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1819914OTHERNVSTATE LICENSE

General Provider Information

NPI Number : 1619532876
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER BALLANTYNE APRN, FNP-C
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2601 N TENAYA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0427
Country : US
Telephone Number : 702-240-8155
Fax Number : 702-240-8161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2019
Last Update Date : 02/12/2026

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Directions to “ HEATHER BALLANTYNE APRN, FNP-C” Practice Location

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