Doctor Name: | MS. LUCINDA JEAN HEAVICAN |
NPI Number: | 1770711582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN NP-C |
License Number: | 111026 |
Business Practice Address: | 358 S 10th St David City, NE - 686322145 |
Business Phone Number: | 4023673322 |
Business Fax Number: | 4023673311 |
Mailing Address: | Po Box 110, DAVID CITY |
State: | NE |
Postal Code: | 686320110 |
Phone Number: | 4023673322 |
Fax Number: | 4023673311 |
NPI Enumeration Date: | 06/30/2009 |
NPI Last Update Date: | 06/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 111026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |