Provider Demographics
NPI:1588969471
Name:FATIGATE, HEATHER NABERS (ARNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NABERS
Last Name:FATIGATE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 SE 16TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2660
Mailing Address - Country:US
Mailing Address - Phone:954-296-4018
Mailing Address - Fax:954-306-3879
Practice Address - Street 1:10301 HAGEN RANCH RD STE 110
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3727
Practice Address - Country:US
Practice Address - Phone:561-738-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9217563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily