Healthcare Provider Details

I. General information

NPI: 1134193931
Provider Name (Legal Business Name): CONNIE ELAINE HEYOB APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONNIE ELAINE LIMBURG NP

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MAIN ST
EAST HELENA MT
59635-9012
US

IV. Provider business mailing address

2047 N LAST CHANCE GULCH # 451
HELENA MT
59601-0744
US

V. Phone/Fax

Practice location:
  • Phone: 423-742-2456
  • Fax:
Mailing address:
  • Phone: 423-742-2456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16152
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13904
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170218
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number220285
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: