Individual
HEATHER TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP
Contact information
Practice address
56 E MAIN ST, WAKEMAN, OH 44889-9492
(216) 267-5445
Mailing address
197 SLEEPY HOLLOW DR, AMHERST, OH 44001-2782
(440) 308-5385
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.347407
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.023337
OH
Other
Enumeration date
04/24/2018
Last updated
01/27/2022
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