Provider Demographics
NPI:1679767131
Name:CLAUS, HEATHER ANN (ARNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:CLAUS
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 1:1 ROCK ISLAND ARSENAL
Mailing Address - Street 2:BUILDING 110, BASEMENT
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61299-7240
Mailing Address - Country:US
Mailing Address - Phone:309-782-0805
Mailing Address - Fax:309-782-0825
Practice Address - Street 1:1 ROCK ISLAND ARSENAL
Practice Address - Street 2:BUILDING 110, BASEMENT
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61299-7240
Practice Address - Country:US
Practice Address - Phone:309-782-0805
Practice Address - Fax:309-782-0825
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-107183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1679767131Medicaid
70742OtherBLUE CROSS
I121438Medicare PIN