Provider Demographics
NPI:1346369329
Name:HEINRICH, NAOMI L (BA)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:L
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:L
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:SOUTH CENTRAL HSC
Mailing Address - Street 2:PO BOX 2055
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58402-2055
Mailing Address - Country:US
Mailing Address - Phone:701-253-6417
Mailing Address - Fax:701-253-6400
Practice Address - Street 1:520 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3016
Practice Address - Country:US
Practice Address - Phone:701-253-6417
Practice Address - Fax:701-253-6400
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator