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NPI Code Detail

MEDICARE: ASHLEE HEINEMANN

MEDICARE: ASHLEE HEINEMANN
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
1164W00000XLicensed Practical NursePN293032PA

General Provider Information

NPI Number : 1790189496
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEE HEINEMANN
Provider Business Mailing Address
First Line : 18279 CONNEAUT LAKE RD
Second Line :
City : MEADVILLE
State : PA
Zip : 16335-3759
Country : US
Telephone Number : 814-337-8383
Fax Number : 814-337-8380
Provider Business Practice Location Address
First Line : 18279 CONNEAUT LAKE RD
Second Line :
City : MEADVILLE
State : PA
Zip : 16335-3759
Country : US
Telephone Number : 814-337-8383
Fax Number : 814-337-8380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2014
Last Update Date : 10/09/2014

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Directions to “ ASHLEE HEINEMANN ” Practice Location

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