Provider Demographics
NPI:1962870790
Name:BEYERS, HEATHER RENEE (WHNP/PMHNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:BEYERS
Suffix:
Gender:F
Credentials:WHNP/PMHNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RENEE
Other - Last Name:GRUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-0752
Mailing Address - Country:US
Mailing Address - Phone:217-827-3770
Mailing Address - Fax:
Practice Address - Street 1:291 N FIREWEED ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7540
Practice Address - Country:US
Practice Address - Phone:907-714-5950
Practice Address - Fax:907-416-7681
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.013001363LP0808X, 363LX0001X
AK217706363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology