Provider Demographics
NPI:1932257177
Name:CHURGIN, HEIDI BETH (AP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:BETH
Last Name:CHURGIN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 SE 5TH TER
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-8127
Mailing Address - Country:US
Mailing Address - Phone:954-933-0555
Mailing Address - Fax:954-942-6780
Practice Address - Street 1:1433 SW 26TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4315
Practice Address - Country:US
Practice Address - Phone:954-933-0555
Practice Address - Fax:954-942-6780
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1173171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist