Provider Demographics
NPI:1831964741
Name:MONG, HEATHER SUE (APRN)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUE
Last Name:MONG
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:SUE
Other - Last Name:MONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HEATHER HARSH
Mailing Address - Street 1:236 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1607
Mailing Address - Country:US
Mailing Address - Phone:330-268-6229
Mailing Address - Fax:
Practice Address - Street 1:236 3RD ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1607
Practice Address - Country:US
Practice Address - Phone:330-754-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health