Heberlie, Gina

Heberlie, Gina is an individual health care provider with primary practice located at 508 W Pine St , Farmington MO 63640-1426. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Heberlie, Gina can be contacted via phone (573) 747-1510.

Contact Information

Primary practice address
508 W Pine St Farmington MO 63640-1426
Phone: (573) 747-1510
Fax: (573) 747-1512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 139404 Missouri

Profile Details

NPI number 1316053028
LBN Legal business name Heberlie, Gina
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Mar 11th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316053028 NPPES
Missouri MEDICAID 429193402

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