Provider Demographics
NPI:1457125247
Name:SPAULDING, HEATHER (APRN-CNS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNS
Mailing Address - Street 1:4650 RANCH HOUSE RD UNIT 82
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4614
Mailing Address - Country:US
Mailing Address - Phone:207-974-8978
Mailing Address - Fax:
Practice Address - Street 1:1800 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2386
Practice Address - Country:US
Practice Address - Phone:702-383-2258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV857331364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics