Provider Demographics
NPI:1407118367
Name:CORTEZ, HEATHER ANN (LPN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:SPOORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:445 MEADOWCREST CT
Mailing Address - Street 2:
Mailing Address - City:MC COMB
Mailing Address - State:OH
Mailing Address - Zip Code:45858-9488
Mailing Address - Country:US
Mailing Address - Phone:419-788-0821
Mailing Address - Fax:
Practice Address - Street 1:445 MEADOWCREST CT
Practice Address - Street 2:
Practice Address - City:MC COMB
Practice Address - State:OH
Practice Address - Zip Code:45858-9488
Practice Address - Country:US
Practice Address - Phone:419-788-0821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 112632164W00000X
OHRN.486800163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No164W00000XNursing Service ProvidersLicensed Practical Nurse