Individual
MR. CHRISTOPHER K HEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
888 S RANCHO DR, LAS VEGAS, NV 89106-3810
(702) 740-4789
(702) 704-8394
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 740-4789
(702) 704-8394
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1505
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02087
NEVADA BORAD OF PHARMACY, #02087
NV
01
—
CS21714
NEVADA BOARD OF LICENSE # CS21714
NV
01
—
PA1505
NEVADA BORAD OF MEDICINE
—
Enumeration date
02/19/2014
Last updated
06/18/2024
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