Provider Demographics
NPI:1467268805
Name:HEIL, ANTOINETTE BRIANNA
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:BRIANNA
Last Name:HEIL
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 1:4111 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1123
Mailing Address - Country:US
Mailing Address - Phone:412-952-7604
Mailing Address - Fax:
Practice Address - Street 1:4111 BRECKENRIDGE DR
Practice Address - Street 2:
Practice Address - City:PRESTO
Practice Address - State:PA
Practice Address - Zip Code:15142-1123
Practice Address - Country:US
Practice Address - Phone:412-952-7604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program