Provider Demographics
NPI:1629559489
Name:HEINE, JAMIE A (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:HEINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:TOOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2615 13TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-4915
Mailing Address - Country:US
Mailing Address - Phone:402-564-7205
Mailing Address - Fax:
Practice Address - Street 1:2615 13TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4915
Practice Address - Country:US
Practice Address - Phone:402-564-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist