Provider Demographics
NPI:1104341775
Name:BURREL, HEATHER REGINA (FNP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:REGINA
Last Name:BURREL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:REGINA
Other - Last Name:BENTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3384 PARIS WAY
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-8721
Mailing Address - Country:US
Mailing Address - Phone:530-713-4770
Mailing Address - Fax:530-713-4770
Practice Address - Street 1:460 PLUMAS BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5005
Practice Address - Country:US
Practice Address - Phone:530-749-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily