Provider Demographics
NPI:1104830215
Name:HECKMAN, VANESSA RENEE (CNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENEE
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745254
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-5254
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:2020 EAKIN RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3572
Practice Address - Country:US
Practice Address - Phone:614-300-9001
Practice Address - Fax:614-675-7824
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.258851163WA0400X
OHCOA.07147-NP363LF0000X
OHAPRN.CNP.07147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2783733Medicaid
OHH068200Medicare PIN
OH2783733Medicaid