Provider Demographics
NPI:1295414969
Name:SCHEIDECKER, HEIDI LYNNE
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNNE
Last Name:SCHEIDECKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18560 CLIFTON RD
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-9633
Mailing Address - Country:US
Mailing Address - Phone:651-443-9692
Mailing Address - Fax:
Practice Address - Street 1:501 2ND ST SE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1603
Practice Address - Country:US
Practice Address - Phone:763-425-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant