Provider Demographics
NPI:1679837991
Name:HEILMAN, HOLLY ANN (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2341
Mailing Address - Country:US
Mailing Address - Phone:443-812-5557
Mailing Address - Fax:
Practice Address - Street 1:53 OLD SOLOMONS ISLAND RD STE C
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3872
Practice Address - Country:US
Practice Address - Phone:410-263-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01994171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist