Provider Demographics
NPI:1588424477
Name:KEARBY, HEATHER (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KEARBY
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 1:4454 S OLD STATE ROAD 145
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-9431
Mailing Address - Country:US
Mailing Address - Phone:812-296-7067
Mailing Address - Fax:
Practice Address - Street 1:8163 W STATE ROAD 56
Practice Address - Street 2:
Practice Address - City:WEST BADEN SPRINGS
Practice Address - State:IN
Practice Address - Zip Code:47469-7706
Practice Address - Country:US
Practice Address - Phone:812-723-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014926A363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care