Provider Demographics
NPI: | 1871082271 |
---|---|
Name: | ARNETT, HEATHER DAWN (APRN-CNP) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | HEATHER |
Middle Name: | DAWN |
Last Name: | ARNETT |
Suffix: | |
Gender: | F |
Credentials: | APRN-CNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 700 ACKERMAN RD STE 2120 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43202-1559 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 614-293-7564 |
Mailing Address - Fax: | 614-293-3320 |
Practice Address - Street 1: | 452 W 10TH AVE |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBUS |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43210-1240 |
Practice Address - Country: | US |
Practice Address - Phone: | 614-366-8030 |
Practice Address - Fax: | 614-366-4545 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2018-05-02 |
Last Update Date: | 2019-11-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | APRN.CNP.023140 | 363L00000X, 363LA2100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0312435 | Medicaid |