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NPI Code Detail

MEDICARE: MRS. HEATHER LYNN KONIARCZYK NP-C

MEDICARE:  MRS. HEATHER LYNN KONIARCZYK  NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerCOA.12507OH

General Provider Information

NPI Number : 1992084297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER LYNN KONIARCZYK NP-C
Provider Business Mailing Address
First Line : 6890 BRIDGECREEK DR
Second Line :
City : CONCORD TWP
State : OH
Zip : 44077-2355
Country : US
Telephone Number : 440-655-5911
Fax Number :
Provider Business Practice Location Address
First Line : 10201 CARNEGIE AVE
Second Line : CA6-61
City : CLEVELAND
State : OH
Zip : 44106-2130
Country : US
Telephone Number : 216-618-2230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2011
Last Update Date : 03/23/2017

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Directions to “ MRS. HEATHER LYNN KONIARCZYK NP-C” Practice Location

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