Provider Demographics
NPI:1376735308
Name:HEIL, BUFFIE (LPN)
Entity Type:Individual
Prefix:
First Name:BUFFIE
Middle Name:
Last Name:HEIL
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 1:324 ELM DR
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2210
Mailing Address - Country:US
Mailing Address - Phone:330-232-0515
Mailing Address - Fax:
Practice Address - Street 1:14 E WATER ST
Practice Address - Street 2:STE 6
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1382
Practice Address - Country:US
Practice Address - Phone:724-745-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH113619164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse