Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 111432 | NE |
N | 363LW0102X | Nurse Practitioner - Women's Health | 111432 | NE |
NPI | 1003243783 |
---|---|
Provider Name | Megan Elizabeth Heusinkvelt |
First Address | Lincoln, NE 68510-4299 |
Second Address | Lincoln, NE 68510-4205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2013 |
Last Update Date | 12/01/2021 |