Healthcare Provider Details
I. General information
NPI: 1487587069
Provider Name (Legal Business Name): RACHEL NICOLE HEITMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1650 HIGH ST
WASHINGTON MO
63090-4354
US
IV. Provider business mailing address
7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US
V. Phone/Fax
- Phone: 877-407-3422
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 2026021401 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: