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NPI Code Detail

MEDICARE: DR. LENE A HEINLEN DO

MEDICARE: DR. LENE A HEINLEN DO
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
1207Q00000XFamily Medicine Physician5101015385MI

General Provider Information

NPI Number : 1841267762
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LENE A HEINLEN DO
Provider Business Mailing Address
First Line : 22738 S COLLINS RD
Second Line :
City : TROUT LAKE
State : MI
Zip : 49793-6812
Country : US
Telephone Number : 989-304-1343
Fax Number :
Provider Business Practice Location Address
First Line : 1140 N STATE ST
Second Line :
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-328-2148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 11/28/2019

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