Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP1152222 | FL |
NPI | 1043226814 |
---|---|
Provider Name | Ms. Elizabeth Ann Heilman |
First Address | Vero Beach, FL 32962-7206 |
Second Address | Port St Lucie, FL 34952-5546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S53172 | (02) | FL |