Provider Demographics
NPI:1841236841
Name:VERMEER-QUIST, HEIDI LYNN (PSYD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNN
Last Name:VERMEER-QUIST
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:LYNN
Other - Last Name:QUIST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2611 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219
Mailing Address - Country:US
Mailing Address - Phone:641-628-9599
Mailing Address - Fax:641-621-1493
Practice Address - Street 1:6200 AURORA AVE
Practice Address - Street 2:STE 302W
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2800
Practice Address - Country:US
Practice Address - Phone:515-331-0303
Practice Address - Fax:515-331-9086
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00965103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI12455Medicare ID - Type Unspecified
IAQ15296Medicare UPIN