Individual
HEIDI D STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6818 AUSTIN CENTER BLVD STE 204, AUSTIN, TX 78731-3100
(512) 867-6211
Mailing address
450 BROOKLINE AVENUE, BOSTON, MA 02215
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5235
AZ
390200000X
Student in an Organized Health Care Education/Training Program
5235
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
754204
—
AZ
Enumeration date
09/26/2012
Last updated
05/03/2022
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