HEIDI E WIMBERLY PA-C NPI 1083797245

NPI Information

NPI: 1083797245
Provider Name: HEIDI E WIMBERLY, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
2600 KINGS HWY
DEPARTMENT OF RADIATION ONCOLOGY
SHREVEPORT, LA
ZIP 71103
Phone: (318) 212-4639
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Heidi E Wimberly, PA-C is a medical physician assistant in Shreveport, LA. Heidi E Wimberly, PA-C NPI is 1083797245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2600 KINGS HWY
DEPARTMENT OF RADIATION ONCOLOGY
SHREVEPORT, LA
ZIP 71103-950
Phone: (318) 212-4639
Fax: (318) 212-8305

The enumeration date for this NPI number is 10/23/2006 and was last updated on 1/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA200094RX	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5F600P790	MEDICARE PIN	LOUISIANA
2	1706566	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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