Provider Demographics
NPI:1740569896
Name:KNUEVE, HEATHER A (CNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:KNUEVE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:5450 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4134
Mailing Address - Country:US
Mailing Address - Phone:614-544-6366
Mailing Address - Fax:614-544-6350
Practice Address - Street 1:3595 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3440
Practice Address - Country:US
Practice Address - Phone:614-566-5456
Practice Address - Fax:614-566-6902
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12603-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0056577Medicaid
OHH023250Medicare PIN