Provider Demographics
NPI:1265917538
Name:HEUTSCHE, HEATHER K (CRNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:HEUTSCHE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:K
Other - Last Name:MCFARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:905 SAHARA TRL
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3687
Mailing Address - Country:US
Mailing Address - Phone:330-729-8970
Mailing Address - Fax:330-729-8971
Practice Address - Street 1:905 SAHARA TRL
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3687
Practice Address - Country:US
Practice Address - Phone:330-729-8970
Practice Address - Fax:330-729-8971
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF11180401363LF0000X
OHAPRN.CNP.025389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0370139Medicaid
PASP019772OtherPA LICENSE