Provider Demographics
NPI:1730057266
Name:ROBERTS, HEATHER MARIE
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:ROBERTS
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 1:1308 WILLIAMSON AVE APT 9B
Mailing Address - Street 2:
Mailing Address - City:NEW MATAMORAS
Mailing Address - State:OH
Mailing Address - Zip Code:45767-9413
Mailing Address - Country:US
Mailing Address - Phone:440-665-0460
Mailing Address - Fax:
Practice Address - Street 1:1308 WILLIAMSON AVE APT 9B
Practice Address - Street 2:
Practice Address - City:NEW MATAMORAS
Practice Address - State:OH
Practice Address - Zip Code:45767-9413
Practice Address - Country:US
Practice Address - Phone:440-665-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide