Provider Demographics
NPI:1528404381
Name:PARDUN, HEATHER A (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:PARDUN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1830
Mailing Address - Country:US
Mailing Address - Phone:402-336-4222
Mailing Address - Fax:402-336-4228
Practice Address - Street 1:304 E DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1830
Practice Address - Country:US
Practice Address - Phone:402-336-4222
Practice Address - Fax:402-336-4228
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily