Provider Demographics
NPI:1245567130
Name:HEINEN, DAWN MARIE (CD (DONA))
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HEINEN
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 3RD ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4022
Mailing Address - Country:US
Mailing Address - Phone:651-428-7088
Mailing Address - Fax:
Practice Address - Street 1:1211 3RD ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-4022
Practice Address - Country:US
Practice Address - Phone:651-428-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula