Provider Demographics
NPI:1164549713
Name:DRESNER, HEIDI M (RN,BC,FNP)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:M
Last Name:DRESNER
Suffix:
Gender:F
Credentials:RN,BC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KENDALL PL
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7759
Mailing Address - Country:US
Mailing Address - Phone:636-294-1363
Mailing Address - Fax:
Practice Address - Street 1:4800 MEXICO RD
Practice Address - Street 2:STE 101
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1666
Practice Address - Country:US
Practice Address - Phone:636-936-0400
Practice Address - Fax:636-936-2252
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO151897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO151897OtherLICENSE NUMBER