Provider Demographics
NPI:1528506854
Name:KADUR, HEATHER (RNFA, CNOR)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KADUR
Suffix:
Gender:F
Credentials:RNFA, CNOR
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 2752
Mailing Address - Street 2:
Mailing Address - City:BUSHNELL
Mailing Address - State:FL
Mailing Address - Zip Code:33513-0123
Mailing Address - Country:US
Mailing Address - Phone:352-457-1482
Mailing Address - Fax:
Practice Address - Street 1:2330 SE 75TH BLVD
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-8011
Practice Address - Country:US
Practice Address - Phone:352-457-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9240912163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant