Individual
MS. ANN HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN ARNP
Contact information
Practice address
17500 W 119TH ST, OLATHE, KS 66061-9524
(913) 660-1616
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(913) 660-1616
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
53-76260-052
KS
363LG0600X
Gerontology Nurse Practitioner
53-76260-052
KS
Other
Enumeration date
02/10/2014
Last updated
04/05/2018
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