Heather Jean Wadehra, RN, APN-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NJ00152200 Issued in NJ

Practice address

621 Beverly Rancocas Rd
Willingboro, NJ 08046-3727

Phone

(609) 877-6800

NPI assigned

May 23, 2007

Last updated

Feb 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Heather Jean Davidson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1649480864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 BEVERLY RANCOCAS RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463727",
            "telephone_number": "609-877-6800",
            "fax_number": "609-877-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BEVERLY RANCOCAS RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463727",
            "telephone_number": "609-877-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADEHRA",
        "first_name": "HEATHER",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN, APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP009606",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00152200",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN570491",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR12877800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sonlight@sonlightmedical.com",
            "affiliation": "Y",
            "endpointDescription": "Secure Email Address",
            "affiliationName": "Son Light Pediatrics PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "621 Beverly Rancocas Rd",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080463727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "DAVIDSON",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "MSN CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.