Provider Demographics
NPI:1922482769
Name:HEIMER, HEIDI MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MARIE
Last Name:HEIMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 DAHLBERG DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4841
Mailing Address - Country:US
Mailing Address - Phone:763-520-7870
Mailing Address - Fax:
Practice Address - Street 1:4040 RADIO DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-3237
Practice Address - Country:US
Practice Address - Phone:651-439-8807
Practice Address - Fax:651-275-4187
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH107493363LA2100X
MN4499363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care