Judy Diane Heinberger

Individual provider Active NPI Licensed Practical Nurse · Lucas, OH

NPI 1649599382 · NPPES record last updated May 20, 2010

Key facts

NPI
1649599382
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN129166 (OH)
Practice address
2752 Dickes Rd
Lucas, OH 44843-9310
Phone
(419) 892-2381
NPI assigned
May 20, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN129166OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN129166 OH Yes

Addresses

Primary practice location

2752 Dickes Rd
Lucas, OH 44843-9310

Mailing address

2752 Dickes Rd
PO Box 521
Lucas, OH 44843-9310
Phone (419) 892-2381

Other providers in Lucas, OH

All providers in Lucas, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.