Provider Demographics
NPI:1063019461
Name:HEILMAN, CIARA DOMINIQUE
Entity Type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:DOMINIQUE
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 LEASURE DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8000
Mailing Address - Country:US
Mailing Address - Phone:740-391-9334
Mailing Address - Fax:
Practice Address - Street 1:175 LEASURE DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8000
Practice Address - Country:US
Practice Address - Phone:740-391-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant