Individual
HEIDE JEAN CLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5045 CARPENTER CREEK DR, PENSACOLA, FL 32503-2521
(850) 712-0379
(888) 249-2325
Mailing address
5045 CARPENTER CREEK DR, PENSACOLA, FL 32503-2521
(850) 712-0379
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103058500
—
FL
Enumeration date
04/25/2019
Last updated
01/25/2022
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