Individual
LEAH HEINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103
(701) 364-8000
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0531
ND
363AS0400X
Surgical Physician Assistant
PAC0531
ND
Other
Enumeration date
04/15/2013
Last updated
11/22/2022
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