Provider Demographics
NPI:1871389825
Name:PFAFF, HEATHER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PFAFF
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:TAPPEN
Mailing Address - State:ND
Mailing Address - Zip Code:58487-9439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3201 33RD ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8823
Practice Address - Country:US
Practice Address - Phone:701-365-4488
Practice Address - Fax:701-365-0727
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR34429163WP0808X
ND202661363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health