Provider Demographics
NPI:1972977403
Name:HEUER, LOURA D (NP)
Entity Type:Individual
Prefix:
First Name:LOURA
Middle Name:D
Last Name:HEUER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604
Mailing Address - Country:US
Mailing Address - Phone:307-234-6765
Mailing Address - Fax:307-234-6998
Practice Address - Street 1:3632 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604
Practice Address - Country:US
Practice Address - Phone:307-234-6765
Practice Address - Fax:307-234-6998
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY19509.1464363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
19509.1464OtherLICENSE