Provider Demographics
NPI:1912472457
Name:HEHER, KATLIN
Entity Type:Individual
Prefix:
First Name:KATLIN
Middle Name:
Last Name:HEHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATLIN
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7691 5 MILE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4348
Mailing Address - Country:US
Mailing Address - Phone:513-624-7246
Mailing Address - Fax:937-949-4870
Practice Address - Street 1:6909 GOOD SAMARITAN DR STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-5209
Practice Address - Country:US
Practice Address - Phone:513-246-7733
Practice Address - Fax:513-852-8719
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF10180357363LF0000X
OHCNP.023752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid