Provider Demographics
NPI:1326772377
Name:HEATH, YOLANDA E (ND, CCA, LPN, CNC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:E
Last Name:HEATH
Suffix:
Gender:F
Credentials:ND, CCA, LPN, CNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 LONE OAK RD STE A
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-4703
Mailing Address - Country:US
Mailing Address - Phone:270-534-4977
Mailing Address - Fax:
Practice Address - Street 1:3530 LONE OAK RD STE A
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-4703
Practice Address - Country:US
Practice Address - Phone:270-534-4977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2044068164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse