Heather Marie Long
Individual provider Active NPI Mastectomy Fitter · Berkeley, MO
NPI 1659919611 · NPPES record last updated Jan 8, 2022
Key facts
- NPI
- 1659919611
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mastectomy Fitter 224900000X
- Practice address
- 6654 Bitteroot LN
Berkeley, MO 63134-1451 - Phone
- (314) 395-5874
- NPI assigned
- Dec 20, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | |||
| Mastectomy Fitter | 224900000X | Yes |
Addresses
Primary practice location
6654 Bitteroot LN
Berkeley, MO 63134-1451
Mailing address
6654 Bitteroot LN
Berkeley, MO 63134-1451
Other providers in Berkeley, MO
- Tamiko Howard
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- Nita F Johnson
- Thomas Lammert
- Steven Robert Larosa
- Love & Flow Phlebotomy
- Emmanuel Eugene McCarrell
- Suzanne Denise McComb
- Bianca Maria Mudd
- Whitney Nelson
All providers in Berkeley, MO · Mastectomy Fitter in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.