Individual
LEA HETLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CRNA
Contact information
Practice address
10 WOODLAND RD, SAINT HELENA, CA 94574-9554
(707) 963-3611
(707) 967-5622
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN728662
CA
367500000X
Certified Registered Nurse Anesthetist
9500045
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95000445
CA
Other
Enumeration date
01/09/2016
Last updated
05/13/2016
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