Provider Demographics
NPI:1225121106
Name:HEIMINK, AMY LEE (RN MSN ANP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:HEIMINK
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Gender:F
Credentials:RN MSN ANP
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Mailing Address - Street 1:ONE PENN PLAZA 8TH FLOOR
Mailing Address - Street 2:OPTUM
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10119-0002
Mailing Address - Country:US
Mailing Address - Phone:646-438-5314
Mailing Address - Fax:
Practice Address - Street 1:ONE PENN PLAZA 8TH FLOOR
Practice Address - Street 2:OPTUM
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0002
Practice Address - Country:US
Practice Address - Phone:646-438-5314
Practice Address - Fax:888-291-2617
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-02-19
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Provider Licenses
StateLicense IDTaxonomies
NY301949363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS61908Medicare UPIN