Provider Demographics
NPI:1588838387
Name:HEINSLER, CHRISTA (ANP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:HEINSLER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 MASCOT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1706
Mailing Address - Country:US
Mailing Address - Phone:585-727-0967
Mailing Address - Fax:585-342-9166
Practice Address - Street 1:290 MASCOT DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1706
Practice Address - Country:US
Practice Address - Phone:585-727-0967
Practice Address - Fax:585-342-9166
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301642363LA2200X
NYF301642-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P019301642OtherEXCELLUS BC BS