Provider Demographics
NPI:1093852972
Name:ZYWIEC, HEIDI M (PA-C)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:ZYWIEC
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:300 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2299
Mailing Address - Country:US
Mailing Address - Phone:402-643-4800
Mailing Address - Fax:402-646-4635
Practice Address - Street 1:250 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2226
Practice Address - Country:US
Practice Address - Phone:402-643-4800
Practice Address - Fax:402-646-4635
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1941008Medicare PIN
NE1003OtherTEMP STATE LICENSE NUMBER