HEARTLAND FUNCTIONAL MEDICINE PC NPI 1316436850

NPI Information

HEARTLAND FUNCTIONAL MEDICINE PC is a family nurse practitioner in Papillion, NE. HEARTLAND FUNCTIONAL MEDICINE PC NPI is 1316436850. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10701 S 72ND ST
PAPILLION, NE
ZIP 68046-427
Phone: (402) 827-9421
Fax: (402) 999-8029

The provider's authorized official is Michelle Mccaslin .
The authorized official title is Owner and has the following contact phone number (402) 827-9421.

The CLIA number assigned to this NPI record is 28D2180266 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2018 and was last updated on 5/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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