Provider Demographics
NPI:1639382914
Name:HEIMANN, SALLY CHURCH (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:CHURCH
Last Name:HEIMANN
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 1:118 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095
Mailing Address - Country:US
Mailing Address - Phone:215-884-1602
Mailing Address - Fax:
Practice Address - Street 1:101 N MERION AVE
Practice Address - Street 2:BRYN MAWR COLLEGE HEALTH CENTER
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-526-7360
Practice Address - Fax:610-526-7365
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001961G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health