Provider Demographics
NPI:1457790974
Name:MOISER, HEATHER LEA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEA
Last Name:MOISER
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-3920
Mailing Address - Country:US
Mailing Address - Phone:580-223-5311
Mailing Address - Fax:580-220-6429
Practice Address - Street 1:1020 N COMMERCE ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-3920
Practice Address - Country:US
Practice Address - Phone:580-223-5311
Practice Address - Fax:580-220-6429
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK78547363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily