Provider Demographics
NPI:1194931428
Name:HEUERMANN, JEFFREY D (BC-HIS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:HEUERMANN
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3807
Mailing Address - Country:US
Mailing Address - Phone:816-313-2800
Mailing Address - Fax:816-792-9819
Practice Address - Street 1:8600 WARD PKWY
Practice Address - Street 2:SUITE 2080
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2614
Practice Address - Country:US
Practice Address - Phone:816-444-4547
Practice Address - Fax:816-444-2892
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO948237700000X
KS889237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36832026OtherBLUE CROSS BLUE SHIELD
MO335699609Medicaid
MO345699607OtherFAMILY HEALTH PARTNERS
MO335699609Medicaid