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CATHLENE MARIE HEIDEMAN ANP, LAC

Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1285867259

Individual Registrant:
 CATHLENE MARIE HEIDEMAN ANP, LAC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3930 PENDER DR OPTIMAL HEALTH DIMENSIONS FAIRFAX, VA 22030-0985 US
Tel: 703-359-9300  Fax: --

Contact information for business:
3930 PENDER DR OPTIMAL HEALTH DIMENSIONS FAIRFAX, VA 22030-0985 US
Tel: 703-359-9300  Fax: --

Registration Information:
NPI: 1285867259
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
VA0024169462
N171100000XOther Service Providers
Acupuncturist
VA0121000640

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS VA - Page 1



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