Provider Demographics
NPI:1386153377
Name:HEINZMAN, JAMIE MAE (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MAE
Last Name:HEINZMAN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:JAMESON
Other - Middle Name:MAE
Other - Last Name:HEINZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:PO BOX 639295 DEPT 93394
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9295
Mailing Address - Country:US
Mailing Address - Phone:248-266-4200
Mailing Address - Fax:855-618-6655
Practice Address - Street 1:16600 W SPRAGUE RD STE 120
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-6300
Practice Address - Country:US
Practice Address - Phone:440-826-0500
Practice Address - Fax:855-618-6655
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018551363LF0000X
OHAPRN.CNP.021761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily