Provider Demographics
NPI:1386934982
Name:COHER, HEIDI J (PA)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:J
Last Name:COHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:J
Other - Last Name:SHLENSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8607 E US HIGHWAY 36 # 100
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7960
Mailing Address - Country:US
Mailing Address - Phone:317-208-3866
Mailing Address - Fax:317-208-3867
Practice Address - Street 1:8607 E US HIGHWAY 36 # 100
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7960
Practice Address - Country:US
Practice Address - Phone:317-208-3866
Practice Address - Fax:317-208-3867
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001266A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10001266OtherPA
INP01291686OtherRAILROAD MEDICARE
IN300005200Medicaid
IN99046364AOtherINDIANA MEDICAL LICENSING AGENCY