Provider Demographics
NPI:1053723296
Name:HEEB, KIMBERLY (WHNP/CNM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HEEB
Suffix:
Gender:F
Credentials:WHNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 E MAIN STREET RD
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-9328
Mailing Address - Country:US
Mailing Address - Phone:716-474-5487
Mailing Address - Fax:716-625-1225
Practice Address - Street 1:253 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1661
Practice Address - Country:US
Practice Address - Phone:716-714-9735
Practice Address - Fax:716-625-1225
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000742367A00000X
NYF-420308-01363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife