Provider Demographics
NPI:1609891738
Name:GUNN, HEIDI LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:LOUISE
Last Name:GUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:LOUISE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:612-262-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN178521400Medicaid
MNA018OtherTRICARE
NA9231014503OtherPREFERRED ONE
767417OtherAMERICA'S PPO
HP23740OtherHEALTH PARTNERS
0102581OtherMEDICA
MN122396C736OtherUCARE MINNESOTA
MN04R43GUOtherBCBS OF MINNESOTA
MN178521400Medicaid
MN178521400Medicaid
MN122396C736OtherUCARE MINNESOTA