Provider Demographics
NPI:1124332143
Name:ASKREN, HEATHER ANN (NP-C, RN, OCN)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:ANN
Last Name:ASKREN
Suffix:
Gender:F
Credentials:NP-C, RN, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 SIERRA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7240
Mailing Address - Country:US
Mailing Address - Phone:765-423-6291
Mailing Address - Fax:765-742-8607
Practice Address - Street 1:1501 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2134
Practice Address - Country:US
Practice Address - Phone:765-423-6291
Practice Address - Fax:765-742-8607
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INA0310023363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN471400017OtherPROVIDER MEDICARE PTAN
IN201013440Medicaid