Basic Information
Provider Information
NPI: 1821377748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRIOR
FirstName: HEATHER
MiddleName: ALISON
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 LAPEER
Address2:  
City: SAGINAW
State: MI
PostalCode: 486071208
CountryCode: US
TelephoneNumber: 9897596464
FaxNumber: 9893998233
Practice Location
Address1: 3884 MONITOR ROAD
Address2:  
City: BAY CITY
State: MI
PostalCode: 487069298
CountryCode: US
TelephoneNumber: 9893712000
FaxNumber: 9896714000
Other Information
ProviderEnumerationDate: 08/09/2011
LastUpdateDate: 04/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X4704266312MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
500G31057001MIMEDICARE PLUS BLUE PPOOTHER
38190832801MIHCAPOTHER
7136801MIHEALTH PLAN OF MICHIGANOTHER
500G31057001MIBLUE CARE NETWORKOTHER
107157201MIMCLAREN HEALTH PLAN OF MICHIGANOTHER
500G31057001MIBCBS OF MICHIGAN TRADITIONALOTHER
182137774805MI MEDICAID


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