Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F-420308-01 | NY |
NPI | 1053723296 |
---|---|
Provider Name | Kimberly Heeb |
First Address | Attica, NY 14011-9328 |
Second Address | East Aurora, NY 14052-1661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 08/02/2022 |