Provider Demographics
NPI:1639454697
Name:PAULSEN, HEATH W (CRNA)
Entity Type:Individual
Prefix:
First Name:HEATH
Middle Name:W
Last Name:PAULSEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:700 E UNIVERSITY AVE
Mailing Address - Street 2:ANESTHESIA DEPARTMENT
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2302
Mailing Address - Country:US
Mailing Address - Phone:515-491-7755
Mailing Address - Fax:515-225-4119
Practice Address - Street 1:700 E UNIVERSITY AVE
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2302
Practice Address - Country:US
Practice Address - Phone:515-491-7755
Practice Address - Fax:515-225-4119
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAD-115347367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered