Provider Demographics
NPI:1952489353
Name:SHINN, HEIDI DAWN (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:DAWN
Last Name:SHINN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:DAWN
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 2432
Mailing Address - Street 2:
Mailing Address - City:BARROW
Mailing Address - State:AK
Mailing Address - Zip Code:99723-2432
Mailing Address - Country:US
Mailing Address - Phone:907-539-2561
Mailing Address - Fax:
Practice Address - Street 1:7000 UULA ST
Practice Address - Street 2:SSMH
Practice Address - City:BARROW
Practice Address - State:AK
Practice Address - Zip Code:99723-1232
Practice Address - Country:US
Practice Address - Phone:907-852-9162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist