Provider Demographics
NPI:1710139399
Name:WILKINS, HEATHER CATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:CATHERINE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:CATHERINE
Other - Last Name:LINDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:701 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-1752
Mailing Address - Country:US
Mailing Address - Phone:308-784-3938
Mailing Address - Fax:308-784-3937
Practice Address - Street 1:701 MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130-1752
Practice Address - Country:US
Practice Address - Phone:308-784-3938
Practice Address - Fax:308-784-3937
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1306098983Medicare PIN