Healthcare Provider Details

I. General information

NPI: 1043132483
Provider Name (Legal Business Name): MRS. JULIE HEAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 TIFFANY DR
MASON CITY IA
50401-1535
US

IV. Provider business mailing address

PO BOX 714
MANLY IA
50456-0714
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP46433
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: