| NPI | 1184287245 |
|---|---|
| Former Name | VANESSA LYNNE HEISTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11002147) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002147) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002147) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2022-07-06 |