Provider Demographics
NPI:1467290262
Name:CONNOLLY, HEATHER LYNN (HBCE)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:HBCE
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:KIVELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:814 E LINN ST
Mailing Address - Street 2:
Mailing Address - City:QUASQUETON
Mailing Address - State:IA
Mailing Address - Zip Code:52326-9747
Mailing Address - Country:US
Mailing Address - Phone:319-415-6735
Mailing Address - Fax:
Practice Address - Street 1:814 E LINN ST
Practice Address - Street 2:
Practice Address - City:QUASQUETON
Practice Address - State:IA
Practice Address - Zip Code:52326-9747
Practice Address - Country:US
Practice Address - Phone:319-415-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula