Individual ProviderHeather BallantyneNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3131 La Canada St Ste 140, Las Vegas, NV 89169-2579(702) 933-9400(702) 216-3346PECOS EnrollmentBased on the most recent information from CMS, provider Heather Ballantyne is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1619532876Provider TypeIndividualFull NameBallantyne, HeatherCredentialAPRN, FNP-CGenderFemaleSole ProprietorYesEnumeration Date5/3/2019Last Updated10/25/2022Contact InformationPractice LocationPractice Address3131 La Canada St Ste 140, Las Vegas, NV 89169-2579Phone(702) 933-9400Fax(702) 933-9444Mailing LocationMailing Address6355 S Buffalo Dr Fl 3, Las Vegas, NV 89113-2133Phone(702) 216-3346FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense819914NevadaProvider IdentifiersIDDescriptionIssuerID819914DescriptionOtherIssuerSTATE LICENSENevada