Provider Demographics
NPI:1275967770
Name:BURNETT, HEATHER LENAE (APN, NP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LENAE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:APN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61790-1426
Mailing Address - Country:US
Mailing Address - Phone:309-438-2956
Mailing Address - Fax:
Practice Address - Street 1:201 N UNIVERSITY
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61790-1426
Practice Address - Country:US
Practice Address - Phone:309-438-2956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily