Individual
MRS. ELAINE A HEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 ENCINO PL NE STE F, ALBUQUERQUE, NM 87102-2639
(505) 272-1312
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3270
TN
363A00000X
Physician Assistant
Primary
PA2013-0056
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47637277
—
NM
05
—
Q032230
—
TN
Enumeration date
09/05/2013
Last updated
03/18/2025
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