Individual provider Active NPI

Nancy Joan Heisterman, FNP

  • Family Nurse Practitioner
  • Nellis Afb, NV
National Provider Identifier
1164405841
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
419970 Issued in CA
Practice address
4700 Las Vegas Blvd N
Amds/SGPT
Nellis Afb, NV 89191-6600
Phone
(702) 653-2890
Fax
(702) 653-2549
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 419970 CA Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Amds/SGPT
Nellis Afb, NV 89191-6600

Mailing address

1827 Autumn Sage Ave
North Las Vegas, NV 89031-1698
Phone (702) 653-2890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
419970CAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164405841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 AUTUMN SAGE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890311698",
            "telephone_number": "702-653-2890",
            "fax_number": "702-653-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "AMDS/SGPT",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2890",
            "fax_number": "702-653-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISTERMAN",
        "first_name": "NANCY",
        "middle_name": "JOAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "419970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis Afb, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.