Provider Demographics
NPI:1437533866
Name:CROSS, HEATHER SUE (CNA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:SUE
Last Name:CROSS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 ANDERS RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-8386
Mailing Address - Country:US
Mailing Address - Phone:269-838-8952
Mailing Address - Fax:
Practice Address - Street 1:4055 ANDERS RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-8386
Practice Address - Country:US
Practice Address - Phone:269-838-8952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver