Provider Demographics
NPI:1477300440
Name:HEYDEN, ISABELLA MAGEE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MAGEE
Last Name:HEYDEN
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 1:2605 SHERMAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3933
Mailing Address - Country:US
Mailing Address - Phone:608-234-0393
Mailing Address - Fax:
Practice Address - Street 1:8908 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1632
Practice Address - Country:US
Practice Address - Phone:301-422-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCNM1061036367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife