Provider Demographics
NPI:1306007075
Name:HECK, KIMBERLY B (FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:B
Last Name:HECK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:B
Other - Last Name:KEOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2709 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3639
Mailing Address - Country:US
Mailing Address - Phone:406-788-5752
Mailing Address - Fax:406-788-5752
Practice Address - Street 1:2709 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-3639
Practice Address - Country:US
Practice Address - Phone:406-788-5752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-30658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily