Provider Demographics
NPI:1184156028
Name:HEINLEIN, DEVIN (NP)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:HEINLEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-883-9088
Mailing Address - Fax:989-883-3551
Practice Address - Street 1:616 UNIONVILLE RD
Practice Address - Street 2:
Practice Address - City:SEBEWAING
Practice Address - State:MI
Practice Address - Zip Code:48759-1631
Practice Address - Country:US
Practice Address - Phone:989-883-9088
Practice Address - Fax:989-883-3551
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704276313363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner