Individual
MS. JENNIFER PIERCE HEANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
610 N MICHIGAN ST, SUITE 400, SOUTH BEND, IN 46601-1077
(575) 647-8120
Mailing address
610 N MICHIGAN ST STE 400, SOUTH BEND, IN 46601-1081
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71005397A
IN
363LF0000X
Family Nurse Practitioner
28171646A
IN
363LF0000X
Family Nurse Practitioner
Primary
71005397A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000925950
BCBS BMG ADVANCED CARDIO SPECIALIST SOUTH BEND
IN
05
—
201284000
—
IN
Enumeration date
02/19/2015
Last updated
12/15/2023
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