Provider Demographics
NPI:1558183780
Name:WORKMAN, HEAVEN
Entity type:Individual
Prefix:
First Name:HEAVEN
Middle Name:
Last Name:WORKMAN
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 1:1260 ST. RT. 97 EAST
Mailing Address - Street 2:LOT 71
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813
Mailing Address - Country:US
Mailing Address - Phone:419-612-1251
Mailing Address - Fax:
Practice Address - Street 1:1260 ST. RT. 97 EAST
Practice Address - Street 2:LOT 71
Practice Address - City:BELLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44813
Practice Address - Country:US
Practice Address - Phone:419-612-1251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle