Provider Demographics
NPI:1366548570
Name:HECKERT, WENDE L (APRN)
Entity type:Individual
Prefix:
First Name:WENDE
Middle Name:L
Last Name:HECKERT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 N 29TH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3251
Mailing Address - Country:US
Mailing Address - Phone:402-371-0263
Mailing Address - Fax:402-379-2285
Practice Address - Street 1:109 N 29TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3251
Practice Address - Country:US
Practice Address - Phone:402-371-0263
Practice Address - Fax:402-379-2285
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110268363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE37866OtherBCBS
S53653Medicare UPIN
279467Medicare PIN