Provider Demographics
NPI:1295754174
Name:HEINER, SARAH CAROL (MD,)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CAROL
Last Name:HEINER
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-7925
Mailing Address - Country:US
Mailing Address - Phone:702-778-8828
Mailing Address - Fax:702-778-8956
Practice Address - Street 1:70 E HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-7925
Practice Address - Country:US
Practice Address - Phone:702-778-8828
Practice Address - Fax:702-778-8956
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC96581Medicare UPIN
NVFI357ZMedicare PIN