Provider Demographics
NPI:1376586362
Name:YEE, HEIDI O'DAY (NP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:O'DAY
Last Name:YEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:O'DAY
Other - Last Name:SHULTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1316 NELSON AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350
Practice Address - Country:US
Practice Address - Phone:209-575-5870
Practice Address - Fax:209-575-5872
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17314-5363L00000X
CA95002267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN133250OtherUCARE
MN2444478OtherAMERICA'S PPO
WI36005800Medicaid
MT4309500Medicaid
MN806T5SHOtherBCBS MN
MN207930500Medicaid
MNHP69349OtherHEALTHPARTNERS
MNP00406072OtherRR MEDICARE
MN1047805OtherPREFERRED ONE
MN01-24253OtherMEDICA
MNB189OtherCHAMPUS
MN1047805OtherPREFERRED ONE