Provider Demographics
NPI:1588034763
Name:PROTTSMAN, HEIDI
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:PROTTSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 N 129TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1804
Mailing Address - Country:US
Mailing Address - Phone:402-561-6130
Mailing Address - Fax:
Practice Address - Street 1:8050 N 129TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-1804
Practice Address - Country:US
Practice Address - Phone:402-561-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12088161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist