Provider Demographics
NPI:1134215288
Name:REEP, HEATH A (ANP)
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:A
Last Name:REEP
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-0850
Mailing Address - Country:US
Mailing Address - Phone:870-226-6786
Mailing Address - Fax:870-226-5101
Practice Address - Street 1:1012 E CHURCH ST
Practice Address - Street 2:SUITE C
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-3509
Practice Address - Country:US
Practice Address - Phone:870-226-6786
Practice Address - Fax:870-226-5101
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146452758Medicaid
AR710815809OtherUNITED HEALTHCARE
AR1279200000OtherQUALCHOICE
AR710815809OtherAETNA
AR710815809OtherHEALTHLINK
AR710815809OtherHEALTHLINK
AR710815809OtherUNITED HEALTHCARE