Provider Demographics
NPI:1063724045
Name:L'HEUREUX, KIMBERLY C (NPP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:C
Last Name:L'HEUREUX
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-0419
Mailing Address - Country:US
Mailing Address - Phone:518-871-1258
Mailing Address - Fax:518-871-1265
Practice Address - Street 1:2911 ROUTE 9
Practice Address - Street 2:SUITE #2
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-3329
Practice Address - Country:US
Practice Address - Phone:518-871-1258
Practice Address - Fax:578-871-1265
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401282363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health