Provider Demographics
NPI:1720501521
Name:HEEBSH, PATRICIA ANN (CNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:HEEBSH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-477-1930
Mailing Address - Fax:
Practice Address - Street 1:5338 PHILADELPHIA DR
Practice Address - Street 2:SUITE B
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3061
Practice Address - Country:US
Practice Address - Phone:937-424-3589
Practice Address - Fax:937-424-0093
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021156363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0236857Medicaid