Provider Demographics
NPI:1194030445
Name:DUMAS, HEIDI DIANE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:DIANE
Last Name:DUMAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:DIANE
Other - Last Name:DITTMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:521 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3649
Mailing Address - Country:US
Mailing Address - Phone:406-395-4305
Mailing Address - Fax:406-395-4858
Practice Address - Street 1:6850 UPPER BOX ELDER RD
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:MT
Practice Address - Zip Code:59521-9073
Practice Address - Country:US
Practice Address - Phone:406-395-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130820-030163W00000X, 363LF0000X
MNR-130332-4163W00000X, 363LF0000X
WI4284-33363LF0000X
MT103462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse