Provider Demographics
NPI:1619365368
Name:HECKMAN, JAIMIE LYNN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JAIMIE
Middle Name:LYNN
Last Name:HECKMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-9037
Mailing Address - Country:US
Mailing Address - Phone:484-336-8477
Mailing Address - Fax:
Practice Address - Street 1:1320 BROADCASTING RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3222
Practice Address - Country:US
Practice Address - Phone:484-336-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN521585L163WU0100X
PASP015618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WU0100XNursing Service ProvidersRegistered NurseUrology