Provider Demographics
NPI:1073311346
Name:HEYMAN, CHANA B
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:B
Last Name:HEYMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 PARK HEIGHTS AVE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1644
Mailing Address - Country:US
Mailing Address - Phone:443-515-7356
Mailing Address - Fax:
Practice Address - Street 1:7121 PARK HEIGHTS AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1644
Practice Address - Country:US
Practice Address - Phone:443-515-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR254626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily