Provider Demographics
NPI:1841795069
Name:HEIDKAMP, DANA N (CRNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:N
Last Name:HEIDKAMP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:N
Other - Last Name:LUCARELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:4815 LIBERTY AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-578-5901
Mailing Address - Fax:412-578-5902
Practice Address - Street 1:4815 LIBERTY AVE STE 215
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-5901
Practice Address - Fax:412-578-5902
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018229363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner