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Individual

MARIEKE NMN HEATWOLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
4101 ARCTIC BLVD STE 104, ANCHORAGE, AK 99503-5702
(907) 677-5910
(907) 600-7711
Mailing address
205 E DIMOND BLVD, ANCHORAGE, AK 99515-1909
(907) 677-5910
(907) 600-7711

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
118269
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
118269
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
165235
AK

Other

Enumeration date
09/02/2020
Last updated
03/17/2022
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