Individual
MRS. LATISHA DAWN HEINLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6516 N OLIE AVE STE G, OKLAHOMA CITY, OK 73116-7399
(405) 608-8060
(405) 608-8070
Mailing address
6516 N OLIE AVE STE G, OKLAHOMA CITY, OK 73116-7399
(405) 608-8060
(405) 608-8070
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
26317
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26317
STATE MEDICAL LICENSE
OK
Enumeration date
06/11/2008
Last updated
06/16/2018
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