Provider Demographics
NPI:1407486194
Name:GEORGE, HEATHER ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:BUCKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 4TH AVE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112
Mailing Address - Country:US
Mailing Address - Phone:641-236-2925
Mailing Address - Fax:641-236-2403
Practice Address - Street 1:202 4TH AVE SUITE 201
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112
Practice Address - Country:US
Practice Address - Phone:641-236-2925
Practice Address - Fax:641-236-2403
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA156428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily