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NPI Code Detail

MEDICARE: HEATHER HEADY

MEDICARE: HEATHER HEADY
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
1363L00000XNurse Practitioner594422KS

General Provider Information

NPI Number : 1801477070
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER HEADY
Provider Business Mailing Address
First Line : PO BOX 1832
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-1832
Country : US
Telephone Number : 620-240-5687
Fax Number :
Provider Business Practice Location Address
First Line : 106 NW VETERANS BLVD
Second Line :
City : MIAMI
State : OK
Zip : 74354-1818
Country : US
Telephone Number : 918-238-3074
Fax Number : 918-238-3076
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2021
Last Update Date : 05/08/2023

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Directions to “ HEATHER HEADY ” Practice Location

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