Provider Demographics
NPI:1053129668
Name:STEMICK, HEATHER (PMHNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:STEMICK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 17TH RD
Mailing Address - Street 2:
Mailing Address - City:BARK RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49807-9553
Mailing Address - Country:US
Mailing Address - Phone:920-242-8893
Mailing Address - Fax:
Practice Address - Street 1:1650 17TH RD
Practice Address - Street 2:
Practice Address - City:BARK RIVER
Practice Address - State:MI
Practice Address - Zip Code:49807-9553
Practice Address - Country:US
Practice Address - Phone:920-242-8893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704342654363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health