Individual
HEATHER LEE SPEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
JOHN DEMPSEY HOSPITAL, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-6700
(860) 679-6736
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
000796
CT
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
000796
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211849
MANAGED HEALTH
—
01
—
400000796CT01
BCBS - FARMINGTON OFFICE
CT
Enumeration date
03/21/2006
Last updated
06/26/2012
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