Individual
PHILLIP HEINEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
950 WINTER ST, WALTHAM, MA 02451-1424
(866) 414-1959
(855) 400-0561
Mailing address
950 WINTER ST, WALTHAM, MA 02451-1424
(866) 414-1959
(855) 400-0561
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN211735
MA
363LF0000X
Family Nurse Practitioner
TEMP246634
AZ
Other
Enumeration date
09/02/2020
Last updated
04/06/2023
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