Provider Demographics
NPI:1346594710
Name:OLAH, HEATHER M (LPN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:OLAH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORWELL
Mailing Address - State:OH
Mailing Address - Zip Code:44076-9430
Mailing Address - Country:US
Mailing Address - Phone:440-313-1002
Mailing Address - Fax:
Practice Address - Street 1:230 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ORWELL
Practice Address - State:OH
Practice Address - Zip Code:44076-9430
Practice Address - Country:US
Practice Address - Phone:440-313-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.136189-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse