IndividualActive
Mary Heinicke, RN CNNP
NPI 1578878112 · Neonatal Nurse Practitioner · St Cloud, MN
Provider details
- NPI number
- 1578878112
- Entity type
- Individual
- Primary specialty
- Neonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RN CNNP
- Sex
- Female
- Sole proprietor
- No
- License
- R097601-1 (MN)
Practice location
1200 Sixth Ave N
Centracare Clinic
St Cloud, MN 56303-2735
Phone: (320) 251-2700
Mailing address
1200 Sixth Ave N
St Cloud, MN 56303-2735
Registry dates
- Enumerated
- 2010-08-06
- Last updated
- 2012-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.