Provider Demographics
NPI:1346743184
Name:BLONDIN, HEATHER MARIE (DO)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:BLONDIN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:HANKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2831 SAINT ROSE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4841
Mailing Address - Country:US
Mailing Address - Phone:702-329-0286
Mailing Address - Fax:
Practice Address - Street 1:2831 SAINT ROSE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4841
Practice Address - Country:US
Practice Address - Phone:702-329-0286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO31272084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program