Individual provider Active NPI

Marian Elizabeth Heesaker, N.P.

  • Family Nurse Practitioner
  • Grand Junction, CO
National Provider Identifier
1194083774
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0990391-NP Issued in CO
Practice address
3090 N 12TH St Unit B
Grand Junction, CO 81506-2804
Phone
(970) 241-2212
Fax
(970) 257-2401
NPI assigned
May 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0990391-NP CO Primary

Addresses

Primary practice location

3090 N 12TH St Unit B
Grand Junction, CO 81506-2804

Mailing address

2754 Compass Dr Ste 377
Grand Junction, CO 81506-8723
Phone (970) 255-7263

Other identifiers 1

IdentifierTypeStateIssuer
18286577MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1194083774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 COMPASS DR STE 377",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068723",
            "telephone_number": "970-255-7263",
            "fax_number": "970-255-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N 12TH ST UNIT B",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062804",
            "telephone_number": "970-241-2212",
            "fax_number": "970-257-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEESAKER",
        "first_name": "MARIAN",
        "middle_name": "ELIZABETH",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990391-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18286577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.