Provider Demographics
NPI:1720647688
Name:SCHAPPACHER, HEATHER MAE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MAE
Last Name:SCHAPPACHER
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 1:2449 ROSS MILLVILLE RD STE B50
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8952
Mailing Address - Country:US
Mailing Address - Phone:513-737-6068
Mailing Address - Fax:513-737-6681
Practice Address - Street 1:2449 ROSS MILLVILLE RD STE B50
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-8952
Practice Address - Country:US
Practice Address - Phone:513-737-6068
Practice Address - Fax:513-737-6681
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024798363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0354066Medicaid