Individual
MS. RONDA M. VANDERHEIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
1560 SUMRALL RD, COLUMBIA, MS 39429-2654
(601) 261-2940
(601) 261-2942
Mailing address
PO BOX 630, COLUMBIA, MS 39429-0630
(601) 261-2940
(601) 261-2942
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R717657
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04155392
—
MS
01
—
2555680
UNITED HEALTH CARE
MS
01
—
4414516P01
CIGNA
MS
01
—
7264860
AETNA
MS
Enumeration date
04/18/2006
Last updated
10/26/2015
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