Provider Demographics
NPI:1134784549
Name:KIRCHHEIMER, HEATHER LYNNE (RN)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNNE
Last Name:KIRCHHEIMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LYNNE
Other - Last Name:WOUGHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1202
Mailing Address - Country:US
Mailing Address - Phone:607-206-1049
Mailing Address - Fax:
Practice Address - Street 1:337 JONES RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3244
Practice Address - Country:US
Practice Address - Phone:607-757-2293
Practice Address - Fax:607-757-2233
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY588250-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool