Provider Demographics
NPI:1104213594
Name:HECKERT HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:HECKERT HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:HECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-371-0263
Mailing Address - Street 1:109 N 29TH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3251
Mailing Address - Country:US
Mailing Address - Phone:402-371-0263
Mailing Address - Fax:402-379-2285
Practice Address - Street 1:109 N 29TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3251
Practice Address - Country:US
Practice Address - Phone:402-371-0263
Practice Address - Fax:402-379-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NES53653Medicare UPIN