Provider Demographics
NPI:1821377748
Name:PRIOR, HEATHER ALISON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALISON
Last Name:PRIOR
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LAPEER
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:3884 MONITOR ROAD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-9298
Practice Address - Country:US
Practice Address - Phone:989-371-2000
Practice Address - Fax:989-671-4000
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI500G310570OtherMEDICARE PLUS BLUE PPO
MI381908328OtherHCAP
MI71368OtherHEALTH PLAN OF MICHIGAN
MI500G310570OtherBLUE CARE NETWORK
MI1071572OtherMCLAREN HEALTH PLAN OF MICHIGAN
MI500G310570OtherBCBS OF MICHIGAN TRADITIONAL
MI1821377748Medicaid
MI381908328OtherHCAP