Healthcare Provider Details

I. General information

NPI: 1184156028
Provider Name (Legal Business Name): DEVIN HEINLEIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 UNIONVILLE RD
SEBEWAING MI
48759-1631
US

IV. Provider business mailing address

1447 N HARRISON ST
SAGINAW MI
48602-4727
US

V. Phone/Fax

Practice location:
  • Phone: 989-883-9088
  • Fax: 989-883-3551
Mailing address:
  • Phone: 989-883-9088
  • Fax: 989-883-3551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704276313
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: