Provider Demographics
NPI:1952545477
Name:OBERST, HEIDI NICHOLE (IDMT, PARAMEDIC)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:NICHOLE
Last Name:OBERST
Suffix:
Gender:F
Credentials:IDMT, PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70239
Mailing Address - Street 2:COMMAND SURGEON
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28307-0239
Mailing Address - Country:US
Mailing Address - Phone:910-243-0526
Mailing Address - Fax:910-243-0161
Practice Address - Street 1:MALVESTI STREET BLDG. 3-3046
Practice Address - Street 2:JSOC AID STATION
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307-0239
Practice Address - Country:US
Practice Address - Phone:910-243-0526
Practice Address - Fax:910-243-0161
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P8008207146L00000X
1710I1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic