Individual
ANGELA CAROL HEAVNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
17273 STATE ROUTE 104 BLDG 27, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
PO BOX 1972, CHILLICOTHE, OH 45601-5972
(614) 226-8031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R168466
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
249462
NC
363LA2200X
Adult Health Nurse Practitioner
5003017
NC
363LA2200X
Adult Health Nurse Practitioner
COA.08278-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871640417
—
NC
05
—
NP2380
—
SC
Enumeration date
01/05/2007
Last updated
07/21/2022
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