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COURTNEY-MAREE HEYNEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1417 S. CLIFF AVE., STE. 401, SIOUX FALLS, SD 57105-1064
(605) 322-8920
(605) 322-8919
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-8919

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CM000065
SD
367A00000X
Advanced Practice Midwife
RN160603
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000972749C
GA
01
202I429644
MEDICARE PTAN
GA
Enumeration date
06/30/2005
Last updated
10/10/2018
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