Individual
MICHAEL JAMES HEDDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2450 W CHARLESTON BLVD, LAS VEGAS, NV 89102
(702) 877-8660
(702) 258-1322
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 242-7308
(702) 240-8790
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA00015
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2402329
—
NV
Enumeration date
01/31/2006
Last updated
04/11/2012
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