Provider Demographics
NPI:1831665058
Name:CORMIER, HEATHER (RN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CORMIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 FURNAS ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1219
Mailing Address - Country:US
Mailing Address - Phone:402-944-2114
Mailing Address - Fax:
Practice Address - Street 1:1842 FURNAS ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1219
Practice Address - Country:US
Practice Address - Phone:402-944-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE79700163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool