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Individual

MRS. HEATHER MARIE EILEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3680 MUIRFIELD DR, MILTON, GA 30004-4493
(513) 375-9195
Mailing address
3680 MUIRFIELD DR, MILTON, GA 30004-4493
(513) 375-9195

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
185382
NC
367500000X
Certified Registered Nurse Anesthetist
NA08700
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN229884
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1902835218
TRICARE
NC
05
8052506
NC
01
P01111638
RAILROAD MEDICARE
NC
Enumeration date
06/30/2006
Last updated
02/15/2021
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