Provider Demographics
NPI:1982006128
Name:CARDILLA, HEATHER (BSN, RN, CNOR, RNFA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:CARDILLA
Suffix:
Gender:F
Credentials:BSN, RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JULIA LN
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-4005
Mailing Address - Country:US
Mailing Address - Phone:732-277-3884
Mailing Address - Fax:
Practice Address - Street 1:2 JULIA LN
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730
Practice Address - Country:US
Practice Address - Phone:732-277-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12769500163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant