Individual
MR. LARRY HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4200
(302) 651-5365
Mailing address
P.O. BOX 191, ROCKLAND, DE 19723-0191
(302) 651-4000
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
L60A00240
DE
367H00000X
Anesthesiologist Assistant
L60A00240
DE
Other
Enumeration date
09/29/2006
Last updated
12/27/2019
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