Doctor Name: | MS. SANDRA JEAN HEATH |
NPI Number: | 1003046558 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R0026953 |
Business Practice Address: | 8810 N 127th East Ave Owasso, OK - 740555016 |
Business Phone Number: | 9187160028 |
Business Fax Number: | |
Mailing Address: | 8810 N 127th East Ave, OWASSO |
State: | OK |
Postal Code: | 740555016 |
Phone Number: | 9187160028 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2009 |
NPI Last Update Date: | 07/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R0026953 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |