Provider Demographics
NPI:1285867291
Name:MCQUILLAN, HEATHER KAY (MS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:KAY
Last Name:MCQUILLAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:KAY
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3700 SHERIDAN BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6100
Mailing Address - Country:US
Mailing Address - Phone:402-489-1834
Mailing Address - Fax:402-489-2046
Practice Address - Street 1:3700 SHERIDAN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6100
Practice Address - Country:US
Practice Address - Phone:402-489-1834
Practice Address - Fax:402-489-2046
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE98402OtherBCBS
NE$$$$$$$$$Medicaid