Provider Demographics
NPI:1700037017
Name:HEIST, ALLISON RENEE (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENEE
Last Name:HEIST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2802
Mailing Address - Country:US
Mailing Address - Phone:513-721-7635
Mailing Address - Fax:513-824-7843
Practice Address - Street 1:2314 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2802
Practice Address - Country:US
Practice Address - Phone:513-721-7635
Practice Address - Fax:513-824-7843
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-10203363L00000X
OHHEI1-0433-5494363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0052510Medicaid