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Individual
HEIDI LINE
Active
Individual
HEIDI LINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
66314
ID
363L00000X
Nurse Practitioner
Primary
2371354
ID
Other
Enumeration date
08/29/2022
Last updated
10/21/2025
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