Provider Demographics
NPI:1013494376
Name:HEILIGSTEDT, ANN E
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:HEILIGSTEDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ADLER CIR STE A
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-6414
Mailing Address - Country:US
Mailing Address - Phone:219-777-0225
Mailing Address - Fax:219-762-3163
Practice Address - Street 1:1605 ADLER CIR STE A
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-6414
Practice Address - Country:US
Practice Address - Phone:219-777-0225
Practice Address - Fax:219-762-3163
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator