Provider Demographics
NPI:1659757425
Name:NEGROTTO, HEATHER K (APRN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:K
Last Name:NEGROTTO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BEECH SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-2013
Mailing Address - Country:US
Mailing Address - Phone:318-259-4435
Mailing Address - Fax:318-395-4260
Practice Address - Street 1:165 BEECH SPRINGS RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2013
Practice Address - Country:US
Practice Address - Phone:318-259-4435
Practice Address - Fax:318-395-4260
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08450363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics