Individual
MRS. MONICA LISABETH HEINEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
615 VIOLA ST, PORT CLINTON, OH 43452-1746
(419) 734-1310
Mailing address
615 VIOLA ST, PORT CLINTON, OH 43452-1746
(419) 734-1310
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400426931104
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2357033
—
OH
Enumeration date
05/14/2007
Last updated
07/09/2007
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