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Individual

HEATHER A THEADERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
6500 LONGLEY LN, RENO, NV 89511-2632
(775) 799-7320
Mailing address
825 E PATRIOT BLVD APT 2058, RENO, NV 89511-1482
(919) 332-0881

Taxonomy

Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
041519007
IL
163WM0705X
Medical-Surgical Registered Nurse
Primary
863800
NV

Other

Enumeration date
07/17/2025
Last updated
07/17/2025
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