Provider Demographics
NPI:1053652453
Name:FICKEN, HEATHER MARIE (CMSRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:FICKEN
Suffix:
Gender:F
Credentials:CMSRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84771 DORRAN RD
Mailing Address - Street 2:
Mailing Address - City:HELIX
Mailing Address - State:OR
Mailing Address - Zip Code:97835-4001
Mailing Address - Country:US
Mailing Address - Phone:541-377-0350
Mailing Address - Fax:
Practice Address - Street 1:84771 DORRAN RD
Practice Address - Street 2:
Practice Address - City:HELIX
Practice Address - State:OR
Practice Address - Zip Code:97835-4001
Practice Address - Country:US
Practice Address - Phone:541-377-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2013-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200341312RN163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical