Provider Demographics
NPI:1013398478
Name:STAPP, HEATHER DAWN (APRN-CNS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:STAPP
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S KEELER AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-6620
Mailing Address - Country:US
Mailing Address - Phone:918-977-5962
Mailing Address - Fax:
Practice Address - Street 1:411 S KEELER AVE
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-6670
Practice Address - Country:US
Practice Address - Phone:918-977-5962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK98244364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist