Provider Demographics
NPI:1316993546
Name:HEILMAN, MICHAEL L (FNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:HEILMAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HERITAGE WAY STE 1200
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3160
Mailing Address - Country:US
Mailing Address - Phone:406-752-6784
Mailing Address - Fax:064-756-4111
Practice Address - Street 1:350 HERITAGE WAY STE 1200
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3160
Practice Address - Country:US
Practice Address - Phone:406-752-6784
Practice Address - Fax:406-756-4111
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201395363L00000X, 363LF0000X
IDNP-1578A363L00000X
MTNUR-APRN-LIC-216717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC500014405OtherMEDICARE RR
SCNP0426Medicaid
NC2599351Medicare UPIN
NC500014405OtherMEDICARE RR
P16921Medicare UPIN
NC2599351AMedicare PIN