Individual
MRS. BARBARA MARIE HECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
412 WRIGHT AVE, MATTYDALE, NY 13211-1542
(315) 437-2478
Mailing address
412 WRIGHT AVE, MATTYDALE, NY 13211-1542
(315) 437-2478
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
128366-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02215543
—
NY
Enumeration date
06/06/2007
Last updated
07/09/2007
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