MEDICARE: MARIA HEAMAN R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	2007004344	MO

General Provider Information

NPI Number	:	1053727131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA HEAMAN R.N.

Provider Business Mailing Address
First Line	:	11155 DUNN RD STE 304E
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6111
Country	:	US
Telephone Number	:	314-741-0911
Fax Number	:	314-741-0501

Provider Business Practice Location Address
First Line	:	11155 DUNN RD STE 304E
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6111
Country	:	US
Telephone Number	:	314-741-0911
Fax Number	:	314-741-0501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	07/09/2014

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Directions to “ MARIA HEAMAN R.N.” Practice Location

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