Provider Demographics
NPI:1275269573
Name:HEALING ADVANCED SOLUTIONS INC
Entity Type:Organization
Organization Name:HEALING ADVANCED SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDLE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:904-619-6227
Mailing Address - Street 1:11643 BEACH BLVD UNIT A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-6604
Mailing Address - Country:US
Mailing Address - Phone:904-373-1661
Mailing Address - Fax:904-619-6227
Practice Address - Street 1:11643 BEACH BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-6604
Practice Address - Country:US
Practice Address - Phone:904-373-1661
Practice Address - Fax:904-619-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9495283OtherLICENSE #