Provider Demographics
NPI:1568562064
Name:LECHNOWSKY, HEATHER THERESE (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:THERESE
Last Name:LECHNOWSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N 102ND CT STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2194
Mailing Address - Country:US
Mailing Address - Phone:402-502-2747
Mailing Address - Fax:402-502-2387
Practice Address - Street 1:1111 N 102ND CT STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2194
Practice Address - Country:US
Practice Address - Phone:402-502-2747
Practice Address - Fax:402-502-2387
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19764207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1969394Medicaid
NE30968OtherBCBS
NE483601477Medicaid
IAP00673794OtherRAILROAD MEDICARE
IA53491OtherBCBS IA
NE390003913OtherRAILROAD MEDICARE
NENA1910003Medicare PIN
NE30968OtherBCBS
NE390003913OtherRAILROAD MEDICARE
NE483601477Medicaid