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Miss Heidi Raquel Childs
Military Health Care Provider in Grand Rapids, Minnesota
NPI 1104024868

Heidi Raquel Childs is a Military Health Care Provider based in Grand Rapids, MN. Heidi Raquel Childs practices in Grand Rapids, MN. The NPI Number for Heidi Raquel Childs is 1104024868 and holds a License No. (Minnesota).

The current practice location address for Heidi Raquel Childs is 29903 Sunny Beach Rd, Grand Rapids, MN and can be reached out via phone at 218-326-1485.

Location: 29903 Sunny Beach Rd, Grand Rapids, MN, 55744-4528
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104024868
Provider Name
Heidi Raquel Childs
Credential
Provider Entity Type
Individual
Gender
Female
Address
29903 Sunny Beach Rd, Grand Rapids, MN, 55744-4528
Phone Number
218-326-1485
Fax Number
Provider Enumeration Date
07/04/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
29903 Sunny Beach Rd
City
Grand Rapids
State
Minnesota
Zip
55744-4528
Phone Number
218-326-1485
Fax Number
person
Provider Business Mailing Address Details
Address
29903 Sunny Beach Rd
City
Grand Rapids
State
Minnesota
Zip
55744-4528
Phone Number
218-326-1485
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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