Healthcare Provider Details

I. General information

NPI: 1043477011
Provider Name (Legal Business Name): NANCY HEDQVIST RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 08/27/2023
Certification Date: 08/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 US HIGHWAY 395 N STE 102-88
GARDNERVILLE NV
89410-7306
US

IV. Provider business mailing address

1362 US HIGHWAY 395 N STE 102-88
GARDNERVILLE NV
89410-7306
US

V. Phone/Fax

Practice location:
  • Phone: 530-318-4077
  • Fax:
Mailing address:
  • Phone: 530-318-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number507306
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number24163
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: