Provider Demographics
NPI:1972735835
Name:L'HEUREUX, MARISA S (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:S
Last Name:L'HEUREUX
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 1:102 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:NE
Mailing Address - Zip Code:68930-5532
Mailing Address - Country:US
Mailing Address - Phone:402-756-8113
Mailing Address - Fax:402-756-2142
Practice Address - Street 1:102 N PINE ST
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:NE
Practice Address - Zip Code:68930-5532
Practice Address - Country:US
Practice Address - Phone:402-756-2141
Practice Address - Fax:402-756-2142
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE111048OtherAPRN