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General NPI Number Information
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NPI Number | 1043011786
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Entity Type | Individual
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Provider Name | HEATHER M TOLVANEN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 9008 VALLEY VIEW DR
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City | LA VISTA
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State | NE
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Zip | 68128-2336
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Country | US
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Telephone | 712-253-3146
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 S CORNELIA ST
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City | SIOUX CITY
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State | IA
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Zip | 51106-1613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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