Individual
HEATHER RENAE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
613 23RD ST STE 230, ASHLAND, KY 41101-2868
(606) 324-4745
(606) 324-4941
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010367
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180569
—
OH
05
—
7100435030
—
KY
Enumeration date
08/09/2016
Last updated
03/03/2022
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