Provider Demographics
NPI:1619416070
Name:HEITMEYER, COURTNEY (CNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:HEITMEYER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MEDICAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4031
Mailing Address - Country:US
Mailing Address - Phone:419-222-6622
Mailing Address - Fax:419-224-0015
Practice Address - Street 1:801 MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-4031
Practice Address - Country:US
Practice Address - Phone:419-222-6622
Practice Address - Fax:419-224-0015
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020454363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner