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General NPI Number Information
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NPI Number | 1558324863
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Entity Type | Individual
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Provider Name | LAURICE ANN HEINE MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12 ST PAUL DR STE 207
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1035
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Country | US
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Telephone | 717-217-6882
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Fax | 717-217-6883
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Provider Business Mailing Address
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Address Line | 785 5TH AVENUE SUITE 3
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-4232
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Country | US
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Telephone | 717-263-9555
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Fax | 717-217-4217
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD048664L
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License Number State | PA
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