Healthcare Provider Details

I. General information

NPI: 1588631790
Provider Name (Legal Business Name): ALLISON HEIMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ALLISON HEIMER KOLLOFSKI MD

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E NICOLLET BLVD FAIRVIEW RIDGES HOSPITAL
BURNSVILLE MN
55337
US

IV. Provider business mailing address

7301 OHMS LANE SUITE 650
EDINA MN
55439
US

V. Phone/Fax

Practice location:
  • Phone: 952-892-2021
  • Fax: 952-892-2670
Mailing address:
  • Phone: 952-835-9880
  • Fax: 952-857-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number47510
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: