Provider Demographics
NPI:1588630602
Name:HEISELMAN, KIMBERLY N (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:N
Last Name:HEISELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15 YORKSHIRE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-7785
Mailing Address - Country:US
Mailing Address - Phone:828-274-1600
Mailing Address - Fax:828-274-1603
Practice Address - Street 1:15 YORKSHIRE ST STE 201
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7785
Practice Address - Country:US
Practice Address - Phone:828-274-1600
Practice Address - Fax:828-274-1603
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC93-00255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8941068Medicaid
NC8941068Medicaid
NC2219295AMedicare ID - Type Unspecified