Provider Demographics
NPI:1295444602
Name:HEYDA, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HEYDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BREZINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11308 CODY LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MN
Mailing Address - Zip Code:56069-1982
Mailing Address - Country:US
Mailing Address - Phone:612-505-6231
Mailing Address - Fax:
Practice Address - Street 1:1030 BLUE GENTIAN RD STE 300
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1662
Practice Address - Country:US
Practice Address - Phone:651-508-0936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNF10220032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner