Provider Demographics
NPI:1801456660
Name:HEILMAN, NOELLE MARIE
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:MARIE
Last Name:HEILMAN
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 1:2200 HAMILTON ST STE 317
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6359
Mailing Address - Country:US
Mailing Address - Phone:610-481-9600
Mailing Address - Fax:
Practice Address - Street 1:2200 HAMILTON ST STE 308
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6359
Practice Address - Country:US
Practice Address - Phone:610-481-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN610349163W00000X
PASP020869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse