Provider Demographics
NPI:1447586193
Name:HEINRICHS, JENNIFER KAY (CPD,LS,CPR CERTIFIED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:HEINRICHS
Suffix:
Gender:F
Credentials:CPD,LS,CPR CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 LITTLE JOHN CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2882
Mailing Address - Country:US
Mailing Address - Phone:770-780-2997
Mailing Address - Fax:
Practice Address - Street 1:2605 LITTLE JOHN CIR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2882
Practice Address - Country:US
Practice Address - Phone:770-780-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula