| Doctor Name: | HEATHER CHEANEY |
| NPI Number: | 1225487143 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 155768 |
| Business Practice Address: | 611 W Main St Fredericktown, MO - 636451111 |
| Business Phone Number: | 5737833341 |
| Business Fax Number: | 5737831096 |
| Mailing Address: | 611 W Main St, FREDERICKTOWN |
| State: | MO |
| Postal Code: | 636451111 |
| Phone Number: | 5737833341 |
| Fax Number: | 5737831096 |
| NPI Enumeration Date: | 06/10/2016 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 155768 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |