MEDICARE: MRS. CHERYL LYNN HECK N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71001937A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730172032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL LYNN HECK N.P.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:	STE 130 PROVIDER ENROLLMENT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8820 S MERIDIAN STREET
Second Line	:	SUITE 120
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-6057
Country	:	US
Telephone Number	:	317-865-6700
Fax Number	:	317-865-6707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	02/24/2014

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