Individual
HEIDI BEOUGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12368 COTTON ST, HOWARD, OH 43028
(740) 504-3632
Mailing address
12368 COTTON STREET, HOWARD, OH 43028
(740) 504-3632
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
162988
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3134576
—
OH
Enumeration date
10/04/2016
Last updated
10/04/2016
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