Provider Demographics
NPI:1194762195
Name:BARTLETT, HEATHER L (CPNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:CPNP
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Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4201 ST. ANTOINE - UHC 5D MAILBOX 226
Mailing Address - Street 2:UNIVERSITY PEDIATRICIANS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-4405
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:3950 BEAUBIEN
Practice Address - Street 2:CHILDRENS HOSPITAL OF MI
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-832-8290
Practice Address - Fax:313-993-0081
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704181315363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics