MEDICARE: BRIDGET E HECKLER CNM

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	367A00000X	Advanced Practice Midwife	COA-00663-NM	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9934723	OTHER	OH	MEDICARE GROUP PTAN
3	H295760	OTHER	OH	MEDICARE INDIVIDUAL PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1447288717	OTHER	OH	GROUP NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497780233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET E HECKLER CNM

Provider Business Mailing Address
First Line	:	200 SAINT CLAIR AVE
Second Line	:
City	:	SAINT MARYS
State	:	OH
Zip	:	45885-2400
Country	:	US
Telephone Number	:	419-300-1129
Fax Number	:	419-394-7313

Provider Business Practice Location Address
First Line	:	1140 S KNOXVILLE AVE STE B
Second Line	:
City	:	SAINT MARYS
State	:	OH
Zip	:	45885-2609
Country	:	US
Telephone Number	:	419-394-7314
Fax Number	:	419-394-7313

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/19/2021

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Directions to “ BRIDGET E HECKLER CNM” Practice Location

Language	Start Address	Practice Location

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