Provider Demographics
NPI:1881261402
Name:HEUTON, ALICIA DORIS (ARNP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:DORIS
Last Name:HEUTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 510TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBERT CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50510-7601
Mailing Address - Country:US
Mailing Address - Phone:712-299-5042
Mailing Address - Fax:
Practice Address - Street 1:1525 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-3027
Practice Address - Country:US
Practice Address - Phone:712-213-8663
Practice Address - Fax:712-213-8020
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA163835363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner