Individual
MRS. MARY ANN HEFFELBOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8170 33RD AVE S # MS 21106W, BLOOMINGTON, MN 55425
(952) 883-6116
Mailing address
8170 33RD AVE S # MS 21106W, BLOOMINGTON, MN 55425-4516
(651) 254-5216
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9671
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
395407200
—
MN
Enumeration date
03/29/2006
Last updated
08/07/2025
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