Provider Demographics
NPI:1801229554
Name:GOLDNER, HEATHER (DNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:GOLDNER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1559
Mailing Address - Country:US
Mailing Address - Phone:732-254-6200
Mailing Address - Fax:732-254-7803
Practice Address - Street 1:53 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1559
Practice Address - Country:US
Practice Address - Phone:732-254-6200
Practice Address - Fax:732-254-7803
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00449600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily