Provider Demographics
NPI:1831654458
Name:STORTS, HEIDI ELIZABETH
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:STORTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 E EASTON ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-7201
Mailing Address - Country:US
Mailing Address - Phone:918-409-1465
Mailing Address - Fax:
Practice Address - Street 1:3307 E EASTON ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-7201
Practice Address - Country:US
Practice Address - Phone:918-409-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist