Provider Demographics
NPI:1336707991
Name:MENEZES, HEATHER-LYNN (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER-LYNN
Middle Name:
Last Name:MENEZES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LANGWORTHY ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7365
Mailing Address - Country:US
Mailing Address - Phone:563-584-3440
Mailing Address - Fax:563-584-3009
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7365
Practice Address - Country:US
Practice Address - Phone:563-584-3440
Practice Address - Fax:563-584-3009
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT019093208000000X
IADO-06036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics