Provider Demographics
NPI:1427261916
Name:HEIDINGER, JANE C (NP)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:C
Last Name:HEIDINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:C
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1210 N 1000 W
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-5013
Mailing Address - Country:US
Mailing Address - Phone:812-847-5304
Mailing Address - Fax:
Practice Address - Street 1:1210 N 1000 W
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-5013
Practice Address - Country:US
Practice Address - Phone:812-847-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000339A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200202950Medicaid
INM400061156Medicare PIN