Provider Demographics
NPI:1326328329
Name:MILLSPAUGH, HEIDI (NP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:MILLSPAUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 N LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-1117
Mailing Address - Country:US
Mailing Address - Phone:765-569-1123
Mailing Address - Fax:765-569-6412
Practice Address - Street 1:727 N LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47872-1117
Practice Address - Country:US
Practice Address - Phone:765-569-1123
Practice Address - Fax:765-569-6412
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28139184A363LF0000X
IN71003670363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily