Provider Demographics
NPI:1578247318
Name:KERBER, HEATHER M
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:M
Last Name:KERBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 WOODINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7013
Mailing Address - Country:US
Mailing Address - Phone:614-306-4259
Mailing Address - Fax:
Practice Address - Street 1:711 WOODINGTON DR
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7013
Practice Address - Country:US
Practice Address - Phone:614-306-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149323164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse