Provider Demographics
NPI:1902417926
Name:PERNE, HEATHER LOUISE (NP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LOUISE
Last Name:PERNE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 W BANCROFT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2507
Mailing Address - Country:US
Mailing Address - Phone:567-377-7721
Mailing Address - Fax:
Practice Address - Street 1:THE UNIVERSITY OF TOLEDO MEDICAL CENTER
Practice Address - Street 2:3000 ARLINGTON AVE
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:419-383-3812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF07191302363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner