Provider Demographics
NPI:1972552172
Name:HEAP, KAREN ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:HEAP
Suffix:
Gender:F
Credentials:PT
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3210
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70434-3210
Mailing Address - Country:US
Mailing Address - Phone:985-340-0102
Mailing Address - Fax:985-419-0220
Practice Address - Street 1:307 W MINNESOTA PARK RD
Practice Address - Street 2:SUITE 8
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6148
Practice Address - Country:US
Practice Address - Phone:985-340-0102
Practice Address - Fax:985-419-0220
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA1054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H153CP01Medicare PIN