MRS. JENIA R HEAVENS (NPI# 1508255662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508255662 |
| Entity Type | Individual |
| Full Name | MRS. JENIA R HEAVENS |
| Credential | FNP-C |
| Practice Address |
12 N 64th St Belleville IL 62223-3809 |
| Mailing Address |
205 Crystal Ln Fairview Heights IL 62208-2963 |
| Practice Telephone | 6183970900 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2019-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
309.008084 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209012258 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12 N 64TH ST |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62223-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457453615 | Kayla Lynne Anderson | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2006-09-01 |
| 1043846587 | Kelsey Stott | Social Worker | 12 N 64th St, Belleville, IL 62223-3809 | 2020-03-17 |
| 1982252201 | Alondra Anderson | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-08-29 |
| 1699236455 | Monique Marie Stroud | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-03-26 |
| 1194280008 | Melissa Marie Huebner | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-02-05 |
| 1790273795 | Joshua B Theiss | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2018-04-25 |
| 1891203535 | Jessica Elizabeth Biffar | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2018-01-16 |
| 1376058164 | Anna Pereira | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2017-12-04 |
| 1831634237 | Chestnut Health Systems, Inc | Clinic/Center | 12 N 64th St, Belleville, IL 62223-3809 | 2016-12-21 |
| 1427591015 | Brandy Hart | Counselor | 12 N 64th St, Suite 5, Belleville, IL 62223-3809 | 2016-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699211268 | Vip Home Health Services, LLC | Home Health | 9454 West Main Street Suite B, Belleville, IL 62223 | 2017-01-06 |
| 1659746063 | Carmel Brown | Counselor | 6400 West Main Suite 3f, Suite 3f, Belleville, IL 62223 | 2015-12-10 |
| 1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
| 1982039921 | Megan Nicole Kirk | Counselor | 8601 W Main St Ste 201, Belleville, IL 62223 | 2013-09-10 |
| 1043555758 | Toni Green | Physical Therapy Assistant | 400 S 74th St, Belleville, IL 62223 | 2012-12-06 |
| 1356626949 | Christopher Patrick Gagen | Pharmacist | 5890 North Belt West, Belleville, IL 62223 | 2011-10-15 |
| 1861777690 | Carmicheal LLC | General Practice | 8601 West Main St., Ste. 101, Belleville, IL 62223 | 2011-10-12 |
| 1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
| 1053616763 | Abdurrahim M Abdulhadi | Anesthesiology | 4500 Mem. Drive, The Memorial Hospital, Belleville, IL 62223 | 2011-01-12 |
| 1801031695 | Jose Jesus Morales | Anesthesiology | 204 Warrensburg Drive, Belleville, IL 62223 | 2008-12-08 |
| Find all providers in zip 62223 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958753 | Rita K Asiedu | Nurse Practitioner | 55 Washington Ave, Belleville, NJ 07109-2931 | 2020-10-08 |
| 1619590205 | Katelyn Rhea Coleman | Nurse Practitioner | 4600 Memorial Dr Ste 220, Belleville, IL 62226-5363 | 2020-05-18 |
| 1225663735 | Sarah Alleman | Nurse Practitioner | 3715 Rolling Meadows Dr, Belleville, IL 62221-0406 | 2020-03-04 |
| 1871130005 | Roselle Monica Pascual David | Nurse Practitioner | 511 Franklin Ave Apt B1, Belleville, NJ 07109-1568 | 2019-12-06 |
| 1003325952 | Kelsey Beasley | Nurse Practitioner | 3060 Harvest Meadow Dr, Belleville, IL 62221-7044 | 2017-09-22 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1518328624 | Crystal Stone | Nurse Practitioner | 100 N Jackson St Ste B, Belleville, IL 62220-1455 | 2016-03-16 |
| 1497181333 | Brittany Murry | Nurse Practitioner | 180 S 3rd St Ste 103, Belleville, IL 62220-1952 | 2013-09-24 |
| 1477893105 | Susan Lynne Bushinski | Nurse Practitioner | 44697 Greenbriar Dr, Belleville, MI 48111-5162 | 2013-02-16 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62223 |
Please comment or provide details below to improve the information on MRS. JENIA R HEAVENS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.