Individual
AMY L HEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7300 TURFWAY RD, FLORENCE, KY 41042-1375
(859) 212-5025
(859) 212-4432
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 212-5025
(859) 212-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30844
KY
208000000X
Pediatrics Physician
35067119
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052796
—
OH
01
—
50024406
PASSPORT MEDICAID
KY
05
—
64982580
—
KY
Enumeration date
02/10/2006
Last updated
05/13/2024
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