Provider Demographics
NPI:1700123502
Name:HEISSERER, ELIZABETH FAYE (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FAYE
Last Name:HEISSERER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:MCCORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2708 S RIFE MEDICAL LN
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-4400
Mailing Address - Fax:479-338-4445
Practice Address - Street 1:2708 S RIFE MEDICAL LN
Practice Address - Street 2:SUITE 220
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-4400
Practice Address - Fax:479-338-4445
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003807363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner