Provider Demographics
NPI:1619252897
Name:MUELLER, HEIDI M (RN)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:MUELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CASTILE
Mailing Address - State:NY
Mailing Address - Zip Code:14427-9509
Mailing Address - Country:US
Mailing Address - Phone:585-243-9000
Mailing Address - Fax:
Practice Address - Street 1:6917 W BERGEN RD
Practice Address - Street 2:
Practice Address - City:BERGEN
Practice Address - State:NY
Practice Address - Zip Code:14416-9743
Practice Address - Country:US
Practice Address - Phone:585-494-1220
Practice Address - Fax:585-494-2613
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY618987-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool