Individual
HEATHER NIMMAGADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CPNP
Contact information
Practice address
3001 6TH ST, GREAT LAKES, IL 60088-2833
(847) 688-4560
Mailing address
6535 RFD, LONG GROVE, IL 60047-2023
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209004994
IL
Other
Enumeration date
05/02/2010
Last updated
05/02/2010
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