Provider Demographics
NPI:1164701314
Name:DUNLAP, HEATHER DIANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DIANE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8882 MYERS RD
Mailing Address - Street 2:
Mailing Address - City:CENTERBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43011-9101
Mailing Address - Country:US
Mailing Address - Phone:614-595-0250
Mailing Address - Fax:888-575-0185
Practice Address - Street 1:8882 MYERS RD
Practice Address - Street 2:
Practice Address - City:CENTERBURG
Practice Address - State:OH
Practice Address - Zip Code:43011-9101
Practice Address - Country:US
Practice Address - Phone:614-595-0250
Practice Address - Fax:888-575-0185
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.258751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse