Provider Demographics
NPI:1982794608
Name:HEIM, DEBORAH (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:HEIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 HIGHWAY 65 NE STE 4
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3349
Mailing Address - Country:US
Mailing Address - Phone:651-482-9160
Mailing Address - Fax:651-925-0053
Practice Address - Street 1:7101 HIGHWAY 65 NE STE 4
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3349
Practice Address - Country:US
Practice Address - Phone:651-482-9160
Practice Address - Fax:651-925-0053
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN064528100Medicaid
MN2C924HEOtherBCBSM