Provider Demographics
NPI:1982902383
Name:STEELY, HEATHER HELENE (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:HELENE
Last Name:STEELY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 ADA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4986
Mailing Address - Country:US
Mailing Address - Phone:501-358-6560
Mailing Address - Fax:
Practice Address - Street 1:2200 ADA AVE STE 301
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4986
Practice Address - Country:US
Practice Address - Phone:501-358-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR198829758Medicaid
AR5AK56Medicare PIN
AR57297Medicare UPIN