Provider Demographics
NPI:1487074894
Name:WOLD, HEIDI MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:WOLD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MARIE KRUGER
Other - Last Name:WOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:161 WASHINGTON STREET
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19438
Mailing Address - Country:US
Mailing Address - Phone:484-351-3010
Mailing Address - Fax:610-862-0808
Practice Address - Street 1:161 WASHINGTON STREET
Practice Address - Street 2:SUITE 1400
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19438
Practice Address - Country:US
Practice Address - Phone:484-351-3010
Practice Address - Fax:610-862-0808
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1865762363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health