| NPI | 1568733541 |
|---|---|
| Former Name | HEIDI MACKERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021634) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000315) |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: IL 238.000315) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2022-07-19 |