Provider Demographics
NPI:1306333927
Name:HECKERT, KRISTA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:MARIE
Last Name:HECKERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4386 STATE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4067
Mailing Address - Country:US
Mailing Address - Phone:989-793-4250
Mailing Address - Fax:989-793-6880
Practice Address - Street 1:5200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3713
Practice Address - Country:US
Practice Address - Phone:989-793-4250
Practice Address - Fax:989-793-6880
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704223285363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner