Provider Demographics
NPI:1740716984
Name:LEWIS, HEATHER MICHELLE (FNP-C, DNP)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MICHELLE
Last Name:LEWIS
Suffix:
Gender:
Credentials:FNP-C, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74924 VERBENA CT
Mailing Address - Street 2:
Mailing Address - City:INDIAN WELLS
Mailing Address - State:CA
Mailing Address - Zip Code:92210-7233
Mailing Address - Country:US
Mailing Address - Phone:909-543-8910
Mailing Address - Fax:
Practice Address - Street 1:73360 HIGHWAY 111 STE 1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3926
Practice Address - Country:US
Practice Address - Phone:760-565-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-09
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006578207QB0002X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine