Provider Demographics
NPI:1992392484
Name:VANDER MAAS, HEATHER ELAINE
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ELAINE
Last Name:VANDER MAAS
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 1:14661 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:OH
Mailing Address - Zip Code:44021-9649
Mailing Address - Country:US
Mailing Address - Phone:440-476-6922
Mailing Address - Fax:
Practice Address - Street 1:14661 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:OH
Practice Address - Zip Code:44021-9649
Practice Address - Country:US
Practice Address - Phone:440-476-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide