MEDICARE: ANNABETH CHERIE HEINZ

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	363A00000X	Physician Assistant	5382	OK

General Provider Information

NPI Number	:	1942188172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNABETH CHERIE HEINZ

Provider Business Mailing Address
First Line	:	8013 NW 151ST CIR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-6083
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 SW 89TH ST STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7919
Country	:	US
Telephone Number	:	405-703-4950
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “ ANNABETH CHERIE HEINZ ” Practice Location

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