Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | COANP01919 | OH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | NCCHEI104267849 | OH |
NPI | 1326214610 |
---|---|
Provider Name | Mrs. Gretchen Ann Heilmann |
First Address | Columbus, OH 43205 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 28/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3023383 | (05) | OH |