Healthcare Provider Details
I. General information
NPI: 1992723548
Provider Name (Legal Business Name): BARBARA SENSKE HEIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 DEERWOOD AVE NW
WADENA MN
56482-1253
US
IV. Provider business mailing address
4 NW DEERWOOD AVENUE
WADENA MN
56482
US
V. Phone/Fax
- Phone: 218-631-1360
- Fax: 218-631-7571
- Phone: 218-631-1360
- Fax: 218-631-7571
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 9728 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: