Provider Demographics
NPI:1528403029
Name:HEUERMANN, JEANETTE NICOLE (APN, NP)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:NICOLE
Last Name:HEUERMANN
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Gender:F
Credentials:APN, NP
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Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 955
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3876
Mailing Address - Country:US
Mailing Address - Phone:312-942-7030
Mailing Address - Fax:312-563-4212
Practice Address - Street 1:621 S NEW BALLAS RD STE 189
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-6335
Practice Address - Fax:314-251-5864
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2018-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209.010390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner