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Individual

GARY HEINZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1351 NEWTOWN PIKE BLDG 5, LEXINGTON, KY 40511-1282
(859) 233-0444
(859) 225-6027
Mailing address
1351 NEWTOWN PIKE BLDG 5, LEXINGTON, KY 40511-1282
(859) 233-0444
(859) 225-6027

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
1081753
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
05/16/2014
Last updated
05/19/2014
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