Healthcare Provider Details

I. General information

NPI: 1104549328
Provider Name (Legal Business Name): ALEXIS HEDDENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 PACIFIC ST
OMAHA NE
68114-5298
US

IV. Provider business mailing address

7525 VALLEY ST
OMAHA NE
68124-3450
US

V. Phone/Fax

Practice location:
  • Phone: 402-343-2600
  • Fax:
Mailing address:
  • Phone: 605-376-2879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number931
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: