Provider Demographics
NPI:1073649695
Name:HEUER, JASON FLORIAN (RN)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:FLORIAN
Last Name:HEUER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 CEDAR AVE S APT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4711
Mailing Address - Country:US
Mailing Address - Phone:612-616-6048
Mailing Address - Fax:
Practice Address - Street 1:3132 CEDAR AVE S APT 2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4711
Practice Address - Country:US
Practice Address - Phone:612-616-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI155462-030163WH0200X
MNR 189055-2367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WH0200XNursing Service ProvidersRegistered NurseHome Health