Individual
MISS ANNE LOUISE HEINOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN FNP
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4917
(765) 502-4023
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209004835
IL
363L00000X
Nurse Practitioner
28221087A
IN
363LF0000X
Family Nurse Practitioner
Primary
71005430A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153475200
—
MN
05
—
201331250
—
IN
01
—
M47140187
MEDICARE
IN
Enumeration date
09/01/2005
Last updated
05/02/2023
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