Provider Demographics
NPI:1003243783
Name:HEUSINKVELT, MEGAN ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:HEUSINKVELT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:POPPENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7001 A STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4299
Mailing Address - Country:US
Mailing Address - Phone:402-488-4022
Mailing Address - Fax:
Practice Address - Street 1:7001 A ST STE 210
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4205
Practice Address - Country:US
Practice Address - Phone:402-488-4022
Practice Address - Fax:402-488-4113
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111432363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health