| Doctor Name: | STEPHANIE HEAVNER |
| NPI Number: | 1043528649 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 31450 |
| Business Practice Address: | 1060 Gaffney Rd Fort Wainwright, AK - 997035001 |
| Business Phone Number: | 9073615692 |
| Business Fax Number: | |
| Mailing Address: | 1060 Gaffney Rd, FORT WAINWRIGHT |
| State: | AK |
| Postal Code: | 997035001 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2010 |
| NPI Last Update Date: | 09/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 31450 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |