Individual
MS. COURTNEY HEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1201 PENN AVE, DES MOINES, IA 50316-2339
(515) 266-1000
Mailing address
2815 HICKMAN RD, DES MOINES, IA 50310-5554
(515) 783-6493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
074808
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01429641
RR MEDICARE
IA
Enumeration date
10/24/2014
Last updated
04/20/2015
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