Healthcare Provider Details

I. General information

NPI: 1770498487
Provider Name (Legal Business Name): BETH ANN HEILMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 S RAINBOW BLVD STE 201
LAS VEGAS NV
89146-6235
US

IV. Provider business mailing address

205 JUNCTION PEAK AVE
NORTH LAS VEGAS NV
89031-6846
US

V. Phone/Fax

Practice location:
  • Phone: 702-749-3110
  • Fax:
Mailing address:
  • Phone: 702-351-4672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: