Provider Demographics
NPI:1457331118
Name:HEINSSEN, JANICE (FNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:HEINSSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WASHINGTON ST
Mailing Address - Street 2:WILMINGTON HOSPITAL ANNEX,
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1024
Mailing Address - Country:US
Mailing Address - Phone:302-255-1300
Mailing Address - Fax:
Practice Address - Street 1:1400 WASHINGTON ST
Practice Address - Street 2:WILMINGTON HOSPITAL ANNEX
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1024
Practice Address - Country:US
Practice Address - Phone:302-255-1300
Practice Address - Fax:302-255-1374
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000104363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP20593Medicare UPIN
DEG01422C01Medicare PIN