Provider Demographics
NPI:1467646331
Name:HEANEY, LANNIE ADELMAN (RN,PHN)
Entity Type:Individual
Prefix:MS
First Name:LANNIE
Middle Name:ADELMAN
Last Name:HEANEY
Suffix:
Gender:F
Credentials:RN,PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 SILVER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-1229
Mailing Address - Country:US
Mailing Address - Phone:415-657-1747
Mailing Address - Fax:415-657-1752
Practice Address - Street 1:1525 SILVER AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-1229
Practice Address - Country:US
Practice Address - Phone:415-657-1747
Practice Address - Fax:415-657-1752
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA192732163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator