Provider Demographics
NPI:1639755747
Name:BRUSS, HEATHER (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BRUSS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:WHITING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2635 LINCOLN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7229
Mailing Address - Country:US
Mailing Address - Phone:563-243-1413
Mailing Address - Fax:563-242-9992
Practice Address - Street 1:2635 LINCOLN WAY STE A
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7229
Practice Address - Country:US
Practice Address - Phone:563-243-1413
Practice Address - Fax:563-242-9992
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022824363L00000X
IAA162114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily