Provider Demographics
NPI:1477977551
Name:BACHERT, HEATHER (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:BACHERT
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15895 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7825 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166-9750
Practice Address - Country:US
Practice Address - Phone:734-586-0888
Practice Address - Fax:734-586-0889
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704236079363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health