Provider Demographics
NPI:1225057417
Name:LEIER, HEATHER M (FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:LEIER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E BROADWAY AVE RM 353
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4082
Mailing Address - Country:US
Mailing Address - Phone:701-255-2048
Mailing Address - Fax:701-255-2066
Practice Address - Street 1:304 E BROADWAY AVE RM 353
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4082
Practice Address - Country:US
Practice Address - Phone:701-255-2048
Practice Address - Fax:701-255-2066
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR26704363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1452854Medicaid
NDN713214Medicare PIN
ND19840Medicaid
ND713214Medicare PIN