Individual
JANE L HEITHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
23751 HIGHWAY 30, CARROLL, IA 51401-0427
(712) 792-9266
(712) 792-5723
Mailing address
23751 HIGHWAY 30, PO BOX 427, CARROLL, IA 51401-0427
(712) 792-9266
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
C-056332
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52501
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
05/01/2007
Last updated
03/18/2008
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