Stacia Lenore Heisler, FNP
Individual provider Active NPI Family Nurse Practitioner · Park Rapids, MN
NPI 1053189449 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1053189449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 11074 (MN)
- Practice address
- 705 Pleasant Ave S
Park Rapids, MN 56470-1440 - Phone
- (218) 732-2800
- NPI assigned
- Dec 14, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Marys Regional Health Center
Practice addresses (Care Compare)
1103 1St St E
Park Rapids, MN 56470-1879
Phone (218) 732-6300
615 6TH St W
Park Rapids, MN 56470-1379
Phone (218) 732-3329
619 6TH St W
Park Rapids, MN 56470-1301
Phone (218) 732-3329
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone (218) 732-2800
Hospital & facility affiliations
- Essentia Health St Marys - Detroit Lakes
- Essentia Health
- St Josephs Area Health Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240305001465 | MN | Practitioner - Nurse Practitioner | 2567807183 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11074 | MN | MD | Physician Assistant |
| F09230590 | ND | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Mary'S Regional Health Center | Current |
Accepting new patients | |
| St. Marys Regional Health Center | Current |
Accepting new patients | |
| St Marys Regional Health Center | Past | Accepting new patients |
Locations
1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300
212 Aspen Ave NE
Menahga, MN 56464
Phone (218) 564-4131
705 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-2800
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F09230590 | ND | |
| Family Nurse Practitioner | 363LF0000X | 11074 | MN | Yes |
Addresses
Primary practice location
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Other names
- Stacey Miller
Other providers in Park Rapids, MN
- Rose A Haroldson
- Nathan Phillip Harris
- Healthy Returns of Minnesota Inc
- Heartland Center of Natural Healing, PLLC
- Heartland Lakes Community School
- Rodney W Helm
- Jennifer M Hillukka
- Elizabeth Hirt
- Alissa Jo Hoban
- Susanne Elaine Holmen
All providers in Park Rapids, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.