Provider Demographics
NPI:1114274925
Name:HEILMAN, EDITH CLAIRE (MSN,PMH,CNS,BC)
Entity Type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:CLAIRE
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:MSN,PMH,CNS,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:610-387-4520
Mailing Address - Fax:610-387-4526
Practice Address - Street 1:100 MARIS GROVE WAY
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1282
Practice Address - Country:US
Practice Address - Phone:610-387-4520
Practice Address - Fax:610-387-4526
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACNS000070364S00000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA908215Medicare UPIN