Provider Demographics
NPI:1528061942
Name:HEIBEIN, DENNIS WILLIAM (CRNA, MSN)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:WILLIAM
Last Name:HEIBEIN
Suffix:
Gender:M
Credentials:CRNA, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VT
Mailing Address - Zip Code:05089-9000
Mailing Address - Country:US
Mailing Address - Phone:802-674-7300
Mailing Address - Fax:802-674-7314
Practice Address - Street 1:289 COUNTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-9000
Practice Address - Country:US
Practice Address - Phone:802-674-7300
Practice Address - Fax:802-674-7314
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043575-23-11367500000X
VT1010091185367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH430067345OtherRAIL ROAD MEDICARE
NH30342168Medicaid
VTHEIB29590OtherBCBS OF VERMONT
NH40Y003605NH01OtherANTHEM BCBS
VT0NA0730Medicaid
NH668510OtherCIGNA
NHAA48568OtherHARVARD PILGRAM HEALTH
NH30342168Medicaid