MEDICARE: HEATHER KAY BIENZ 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
1	363LF0000X	Family Nurse Practitioner	354465	NY

General Provider Information

NPI Number	:	1750123873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER KAY BIENZ FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 100
Second Line	:
City	:	ELBRIDGE
State	:	NY
Zip	:	13060-0100
Country	:	US
Telephone Number	:	315-685-0247
Fax Number	:

Provider Business Practice Location Address
First Line	:	6221 STATE ROUTE 31 STE 105
Second Line	:
City	:	CICERO
State	:	NY
Zip	:	13039-8715
Country	:	US
Telephone Number	:	315-752-3000
Fax Number	:	315-685-0222

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

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	03/24/2026

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