Provider Demographics
NPI:1316162050
Name:SEIBERS, HEATHER LYNN (RN,BSN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:SEIBERS
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 GREYHOUND PARK RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-2406
Mailing Address - Country:US
Mailing Address - Phone:563-271-9773
Mailing Address - Fax:
Practice Address - Street 1:1795 GREYHOUND PARK RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-2406
Practice Address - Country:US
Practice Address - Phone:563-271-9773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107367163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38346400Medicaid
IA107367OtherIOWA RN