Individual
HEATHER RENEE MACLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NMNP - PP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
095000395N5
OR
367A00000X
Advanced Practice Midwife
Primary
095000395N5
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090501
—
OR
01
—
1407812365
NBMC NPI NUMBER-GROUP
OR
01
—
420001224
RR MEDICARE PTAN NUMBER
OR
01
—
CD8723
RR MEDICARE GROUP NUMBER
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
12/06/2005
Last updated
07/18/2024
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