Provider Demographics
NPI:1578001277
Name:HEGGE, ANDREA M (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:HEGGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:M
Other - Last Name:AERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4525 S 86TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9277
Mailing Address - Country:US
Mailing Address - Phone:402-483-7507
Mailing Address - Fax:402-483-6899
Practice Address - Street 1:4525 S 86TH ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9277
Practice Address - Country:US
Practice Address - Phone:402-483-7507
Practice Address - Fax:402-483-6899
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2098363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068397013Medicaid
IA1578001277 - ORD/REFMedicaid
NE47037660404Medicaid
NE47037660404Medicaid