Provider Demographics
NPI:1811583750
Name:EICHORN, HEIDEN
Entity Type:Individual
Prefix:
First Name:HEIDEN
Middle Name:
Last Name:EICHORN
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 1:8150 STATE ROUTE 314
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904-9684
Mailing Address - Country:US
Mailing Address - Phone:419-631-5242
Mailing Address - Fax:
Practice Address - Street 1:8150 STATE ROUTE 314
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904-9684
Practice Address - Country:US
Practice Address - Phone:419-631-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker