Provider Demographics
NPI:1073948758
Name:FORBES, HEATHER (CDM, CPM)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:CDM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 W MARYDALE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7501
Mailing Address - Country:US
Mailing Address - Phone:907-262-9446
Mailing Address - Fax:907-262-9354
Practice Address - Street 1:154 W MARYDALE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7501
Practice Address - Country:US
Practice Address - Phone:907-262-9446
Practice Address - Fax:907-262-9354
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK74176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife