MEDICARE: LINDSEY MARIE HEIDELBACH CRNP

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	363L00000X	Nurse Practitioner	SP025232	PA

General Provider Information

NPI Number	:	1619610334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY MARIE HEIDELBACH CRNP

Provider Business Mailing Address
First Line	:	113 ALPINE CIR
Second Line	:
City	:	ROSTRAVER TOWNSHIP
State	:	PA
Zip	:	15012-6821
Country	:	US
Telephone Number	:	724-554-4249
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BROOKS LN STE 180
Second Line	:
City	:	JEFFERSON HILLS
State	:	PA
Zip	:	15025-3769
Country	:	US
Telephone Number	:	412-469-3600
Fax Number	:	412-469-3630

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

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	10/30/2023

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