Provider Demographics
NPI:1366783326
Name:HEILMAN, ALLI MARIE (NP)
Entity type:Individual
Prefix:
First Name:ALLI
Middle Name:MARIE
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:OH
Mailing Address - Zip Code:44846-9763
Mailing Address - Country:US
Mailing Address - Phone:419-276-2952
Mailing Address - Fax:
Practice Address - Street 1:34 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:OH
Practice Address - Zip Code:44846-9763
Practice Address - Country:US
Practice Address - Phone:419-276-2952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA. 14338-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner