MRS. HEATHER ELIZABETH POLK APRN - NPI 1053973081 - Nurse Practitioner in Sikeston, MO

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.

On this page

About Mrs. Heather Elizabeth Polk Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. HEATHER ELIZABETH POLK APRN (NPI 1053973081) is an individual primary care provider in Sikeston, Missouri, licensed in Missouri (2019022989) and active in the NPI registry since June 2019. She maintains 3 additional practice locations.

NPPES Registry Identity

NPI1053973081

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameMRS. HEATHER ELIZABETH POLKCredential: APRN

Location Address200 SOUTHLAND DRSikeston, MO 63801-4403

Mailing Address6738 State Highway 77Benton, MO 63736-8238 · (573) 313-2500 · Fax (573) 313-2500

Phone(573) 472-1770

Fax(573) 472-4050

Sole ProprietorYes

Enumeration DateJune 29, 2019

Last NPPES UpdateApril 14, 2020

NPPES CertifiedApril 14, 2020

✔ NPI 1053973081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in MO · 2019022989

200 SOUTHLAND DR, Sikeston, MO 63801

Open in Google Maps ↗

Secondary Practice Locations 3

Location 1941 Davis StNew Madrid, MO 63869-1607 · Phone (573) 521-6787

Location 2109 E 5th StCaruthersville, MO 63830-1417 · Phone (573) 359-9803 · Fax (573) 359-0990

Location 3421 Semo DrNew Madrid, MO 63869-1733 · Phone (573) 748-2592 · Fax (573) 748-2673

Other Identifiers 2

Other2019022989MO · Missouri State Board Of Nursing

Medicaid420077159MO

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE E JANSEN FNP

Nurse Practitioner (Family)