Organization
VI SANO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER M MASON AGACNP-BC (OWNER)
(330) 692-1641
Entity
Organization
Contact information
Practice address
7556 STATE ROUTE 45 STE B, LISBON, OH 44432-9807
(330) 870-4127
(330) 870-4139
Mailing address
7556 STATE ROUTE 45 STE B, LISBON, OH 44432-9807
(330) 870-4127
(330) 870-4139
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115037
—
OH
05
—
0381705
—
OH
Enumeration date
06/06/2022
Last updated
06/06/2022
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