Individual
LAUREN D HECKETHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-4740
(505) 253-6300
(316) 265-4480
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
76045
NM
363LG0600X
Gerontology Nurse Practitioner
53-78202
KS
Other
Enumeration date
05/15/2018
Last updated
11/22/2023
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