Provider Demographics
NPI:1841990785
Name:HEIL, ROBERT SEAN (RN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SEAN
Last Name:HEIL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9547 IONA AVE
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8808
Mailing Address - Country:US
Mailing Address - Phone:852-104-4957
Mailing Address - Fax:
Practice Address - Street 1:9547 IONA AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-8808
Practice Address - Country:US
Practice Address - Phone:559-305-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95207946163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse