Provider Demographics
NPI:1750689733
Name:YATES, HEATHER LYNN (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:YATES
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNN
Other - Last Name:MCCONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:495 COOPER RD STE 325
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8734
Mailing Address - Country:US
Mailing Address - Phone:614-508-2223
Mailing Address - Fax:614-508-2233
Practice Address - Street 1:495 COOPER RD STE 325
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8734
Practice Address - Country:US
Practice Address - Phone:614-508-2223
Practice Address - Fax:614-508-2233
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA12201 NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0096624Medicaid