Individual
CALEB AARON HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1111
Mailing address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2023022977
MO
Other
Enumeration date
06/16/2023
Last updated
10/24/2023
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