Provider Demographics
NPI:1043070352
Name:HEATON, TATIANA ALEKSANDRA
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:ALEKSANDRA
Last Name:HEATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TATIANA
Other - Middle Name:ALEKSANDRA
Other - Last Name:CURRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCMA
Mailing Address - Street 1:2555 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-2723
Mailing Address - Country:US
Mailing Address - Phone:541-883-2795
Mailing Address - Fax:
Practice Address - Street 1:2555 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-2723
Practice Address - Country:US
Practice Address - Phone:541-883-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician