Provider Demographics
NPI:1164875894
Name:HEILMANN, SCOTT R (FNP, RNFA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:R
Last Name:HEILMANN
Suffix:
Gender:M
Credentials:FNP, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 PANAMA CITY BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-2607
Mailing Address - Country:US
Mailing Address - Phone:850-234-5151
Mailing Address - Fax:850-234-3303
Practice Address - Street 1:12007 PANAMA CITY BEACH PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407
Practice Address - Country:US
Practice Address - Phone:850-234-5151
Practice Address - Fax:850-234-3303
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9335171163WR0006X
FLARNP9335171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZF6HROtherBCBS FL