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NPI Code Detail

MEDICARE: HEIDI BEARDSLEY LPN

MEDICARE: HEIDI BEARDSLEY LPN
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
1164W00000XLicensed Practical Nurse7040AK

General Provider Information

NPI Number : 1730630716
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI BEARDSLEY LPN
Provider Business Mailing Address
First Line : 1423 PEGER RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5169
Country : US
Telephone Number : 907-371-1300
Fax Number : 907-371-1387
Provider Business Practice Location Address
First Line : 1423 PEGER RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5169
Country : US
Telephone Number : 907-371-1300
Fax Number : 907-371-1387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2016
Last Update Date : 08/16/2022

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Directions to “ HEIDI BEARDSLEY LPN” Practice Location

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