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General NPI Number Information
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NPI Number | 1912882986
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Entity Type | Individual
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Provider Name | BRANDON HEENEY ARNP
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Gender | Male
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2355 HIGHWAY 36 W STE 400
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City | SAINT PAUL
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 763-412-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 716 S ARTHUR ST APT 32
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City | SPOKANE
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State | WA
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Zip | 99202-2492
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Country | US
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Telephone |
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 70023942
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License Number State | WA
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