Provider Demographics
NPI:1619596848
Name:PRESSON, HEIDI R
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:R
Last Name:PRESSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416842 MUSCOGEE LN
Mailing Address - Street 2:
Mailing Address - City:CHECOTAH
Mailing Address - State:OK
Mailing Address - Zip Code:74426-2359
Mailing Address - Country:US
Mailing Address - Phone:206-833-9096
Mailing Address - Fax:
Practice Address - Street 1:416842 MUSCOGEE LN
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426-2359
Practice Address - Country:US
Practice Address - Phone:206-833-9096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty