Individual
HEIDI GENEREUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
2400 ST FRANCIS DR, BRECKENRIDGE, MN 56520-1025
(218) 643-3000
(574) 268-0684
Mailing address
PO BOX 1296, WARSAW, IN 46581-1296
(574) 268-9640
(574) 268-0684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 095825 9
MN
367500000X
Certified Registered Nurse Anesthetist
R20219
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12110
—
ND
05
—
149842800
—
MN
01
—
430051818
PALMETTO GBA - RAILROAD MEDICARE
MN
01
—
430051818
PALMETTA GBA - RAILROAD MEDICARE
ND
Enumeration date
08/23/2006
Last updated
08/14/2013
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