HEIDI GRONDAHL (NPI# 1962921049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962921049 |
| Entity Type | Individual |
| Full Name | HEIDI GRONDAHL |
| Credential | PA-C |
| Practice Address |
Building 2, Del Din Clinic Apo AE 09606 |
| Mailing Address |
Cmr 473 Box 1285 Apo AE 09606-0013 |
| Practice Telephone | 3146369764 |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2018-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4430 Missouri Ave, Fort Leonard Wood, MO 654739098 | 7193104153 | |
| Building 2, Del Din Clinic, Apo, AE 09606 | 3146369764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619281987 | Heidi Lynn Grondahl | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2010-07-29 |
| Street Address |
BUILDING 2, DEL DIN CLINIC |
| City | APO |
| State | AE |
| Zip Code | 09606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144773433 | Marsha Lynn Baker | Social Worker | Cmr 473, Box 624, Apo, AE 09606-0007 | 2016-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194654 | Megan Mccann | Social Worker | Hq Meddacb, Unit 28038 Bld 700, Apo, AE 09112 | 2020-11-06 |
| 1144821588 | Leona Marie Walker | Registered Nurse | Bldg. 650 Huebner Road, Fort Riley, 66442, Apo, AA 66442 | 2020-11-03 |
| 1699375360 | Erin Rosa Moore-preston | Radiology | Us Army Medical Activity- Bavaria, Unit 28038, Apo, AE 09112 | 2020-10-30 |
| 1811597578 | Desirae Leann Chitishvili | Nurse's Aide | Us Army Medical Activity-bavaria Unit 28038, Attn: Mceu-bav-cre, Apo, AE 09112 | 2020-10-30 |
| 1255931689 | Stephanie Ann Lyons | Social Worker | Psc 80 Box 608, Apo, AP 96367-9998 | 2020-10-26 |
| 1154920940 | Kyle Leo Price | Military Health Care Provider | Uss Oklahoma City, Apo, AP 96932 | 2020-10-22 |
| 1740889559 | Caitlyn Paige Parnell | Registered Nurse | Patch Barracks Illinoisstrasse 70569, Bld 2300, Apo, AE 09046 | 2020-10-22 |
| 1336747799 | John Daniel Generous | Physician Assistant | Bastogne St, Bldg 5-4257 Clark Health Clinic Fort Bragg, Apo, AA 18310 | 2020-10-16 |
| 1093312928 | Richard Keith Smith | Physical Therapist | Landstuhl Regional Medical Centr, Apo, AE 09067 | 2020-10-05 |
| 1154938520 | Jacob Steven Blackhurst | Dentist | Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302 | 2020-09-29 |
| Find all providers in APO | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730700253 | Udaya Dahal | Military Health Care Provider | Grafenwoehr, De Tower Barracks, Usag-b, Apo, AE 09114 | 2020-05-06 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1538795679 | Tanner Sean Harvey | Military Health Care Provider | 1mrb Bas, Apo, AA 92010 | 2020-03-20 |
| 1124686472 | Oscar Christian | Military Health Care Provider | Hospital: Wh3s9a 549 Hc/baach, Unit 15245, Apo, AP 96271 | 2019-06-02 |
| 1932687340 | Jennifer Marie Sisson | Military Health Care Provider | 4-2 Arb, Apo, AP 96271 | 2018-07-30 |
| 1922546654 | Alexandria Fraleigh Jaksha | Military Health Care Provider | Blg 8740 Unit 23809, Cmr 405, Bx 52, Apo, AE 09034 | 2017-02-01 |
| 1447702154 | Jerry C Mallory Jr. | Military Health Care Provider | 4018 Bayard 44121, Apo, AA 44121 | 2016-10-28 |
| 1306226121 | Clinton Rebello | Military Health Care Provider | Mcguire Afb, Apo, AA 08610 | 2015-06-06 |
| 1255661005 | Thomas J Drummond | Military Health Care Provider | Hhc 3-4 Inf, Cmr 405 Box #5427, Apo, AE 09034 | 2009-12-29 |
| 1194851261 | Rodolfo Lim Cubacub | Military Health Care Provider | Cmr 457, Box 639, Apo, AE 09033 | 2007-02-26 |
| Find all providers in APO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.