Provider Demographics
NPI:1164895371
Name:KING, HEATHER LOUISE (NP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LOUISE
Last Name:KING
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LOUISE
Other - Last Name:ST. PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4179 S RIVERBOAT RD STE 220
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2986
Mailing Address - Country:US
Mailing Address - Phone:801-590-9267
Mailing Address - Fax:
Practice Address - Street 1:16201 E INDIANA AVE STE 3100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2844
Practice Address - Country:US
Practice Address - Phone:509-418-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP1651A363LF0000X
MN4208363LF0000X
ID1651363LF0000X
WAAP61219055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily