Provider Demographics
NPI:1023378783
Name:HEARD, CORAL DENISE (ANP)
Entity Type:Individual
Prefix:
First Name:CORAL
Middle Name:DENISE
Last Name:HEARD
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:CORAL
Other - Middle Name:DENISE
Other - Last Name:RAINWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 WRIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6240
Mailing Address - Country:US
Mailing Address - Phone:501-321-9803
Mailing Address - Fax:501-321-0710
Practice Address - Street 1:115 WRIGHTS ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6240
Practice Address - Country:US
Practice Address - Phone:501-321-9803
Practice Address - Fax:501-321-0710
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily