Provider Demographics
NPI:1225593635
Name:HEATH, AMY DIRR
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:DIRR
Last Name:HEATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:4323 GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-1507
Mailing Address - Country:US
Mailing Address - Phone:513-636-9821
Mailing Address - Fax:513-636-9820
Practice Address - Street 1:4323 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1507
Practice Address - Country:US
Practice Address - Phone:513-636-9821
Practice Address - Fax:513-636-9820
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN248574163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse