Provider Demographics
NPI:1659692135
Name:BLOESSER, HEATHER (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BLOESSER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 E ROCK HAVEN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-4414
Mailing Address - Country:US
Mailing Address - Phone:816-380-7470
Mailing Address - Fax:813-887-0350
Practice Address - Street 1:2820 E ROCK HAVEN RD STE 210
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-4414
Practice Address - Country:US
Practice Address - Phone:816-380-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine