Provider Demographics
NPI:1326286253
Name:HEIKENS, JOAN E (BSN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:HEIKENS
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E. HANAGITA
Mailing Address - Street 2:
Mailing Address - City:VALDEZ
Mailing Address - State:AK
Mailing Address - Zip Code:99686-1635
Mailing Address - Country:US
Mailing Address - Phone:907-835-5032
Mailing Address - Fax:
Practice Address - Street 1:1300 E. HANAGITA
Practice Address - Street 2:
Practice Address - City:VALDEZ
Practice Address - State:AK
Practice Address - Zip Code:99686-1635
Practice Address - Country:US
Practice Address - Phone:907-835-5032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK302R00000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management