Provider Demographics
NPI:1194073916
Name:HEIDEL, JANICE PRICE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:PRICE
Last Name:HEIDEL
Suffix:
Gender:F
Credentials:ARNP
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 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:863-701-4256
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:6416 OLD WINTER GARDEN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-1348
Practice Address - Country:US
Practice Address - Phone:863-701-4256
Practice Address - Fax:407-770-0661
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP666182363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health