Provider Demographics
NPI:1235309147
Name:HEIMANN, PATRICIA ANN (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:HEIMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:ILLIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2841 HARTLAND RD STE 403
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3500
Mailing Address - Country:US
Mailing Address - Phone:703-646-2250
Mailing Address - Fax:
Practice Address - Street 1:4251 LEGION RD STE 107
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-6200
Practice Address - Country:US
Practice Address - Phone:910-429-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21595225100000X, 225100000X
VA2305213208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400001057Medicare PIN