Provider Demographics
NPI:1730377102
Name:POBLETE, HEATHER (APN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:POBLETE
Suffix:
Gender:F
Credentials:APN
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1345 KUSER RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3823
Mailing Address - Country:US
Mailing Address - Phone:609-581-1878
Mailing Address - Fax:609-581-2632
Practice Address - Street 1:1345 KUSER RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3823
Practice Address - Country:US
Practice Address - Phone:609-581-1878
Practice Address - Fax:609-581-2632
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2024-06-04
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Provider Licenses
StateLicense IDTaxonomies
NY304707364SA2200X
NJ26NJ00425800364SA2200X
NJ26NR16474300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health