Provider Demographics
NPI:1578334504
Name:ABBOTT, HEIDI JEAN (CNM)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:JEAN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:765-473-6400
Mailing Address - Fax:260-479-2923
Practice Address - Street 1:285 W 12TH ST STE 205
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1654
Practice Address - Country:US
Practice Address - Phone:765-473-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-05-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife