Provider Demographics
NPI:1629820147
Name:CANCIENNE, HEATHER LOUISE (DO)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LOUISE
Last Name:CANCIENNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:RESERVE
Mailing Address - State:LA
Mailing Address - Zip Code:70084-5500
Mailing Address - Country:US
Mailing Address - Phone:985-210-5846
Mailing Address - Fax:
Practice Address - Street 1:120 CEDAR DR
Practice Address - Street 2:
Practice Address - City:RESERVE
Practice Address - State:LA
Practice Address - Zip Code:70084-5500
Practice Address - Country:US
Practice Address - Phone:985-210-5846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program