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NPI Code Detail

MEDICARE: MR. JOSEPH PATTON HEATHERLY MSW

MEDICARE: MR. JOSEPH PATTON HEATHERLY MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker951NE

General Provider Information

NPI Number : 1881558542
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH PATTON HEATHERLY MSW
Provider Business Mailing Address
First Line : 918 S 36TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68510-3431
Country : US
Telephone Number : 402-486-7835
Fax Number :
Provider Business Practice Location Address
First Line : 420 VICTORY PARK DR
Second Line :
City : LINCOLN
State : NE
Zip : 68510-2484
Country : US
Telephone Number : 402-486-7835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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