Provider Demographics
NPI:1427694009
Name:HEIMAN, ALLISON MARIE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 4TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:MN
Mailing Address - Zip Code:55731-2236
Mailing Address - Country:US
Mailing Address - Phone:218-365-5254
Mailing Address - Fax:
Practice Address - Street 1:111 S 4TH AVE E
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:MN
Practice Address - Zip Code:55731-2236
Practice Address - Country:US
Practice Address - Phone:218-365-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker