Individual
NICOLE LYN HEIGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13194 S CEDAR RD, CEDAR, MI 49621-9581
(231) 835-0693
Mailing address
8610 BENT PINE DR, LAKE ANN, MI 49650-9414
(231) 357-3438
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
821601257
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703121386
NURSING LICENSE
MI
Enumeration date
08/26/2019
Last updated
08/26/2019
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