Healthcare Provider Details

I. General information

NPI: 1215856414
Provider Name (Legal Business Name): HEATHER YORK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7974 WAGGONER RUN DR
BLACKLICK OH
43004-9017
US

IV. Provider business mailing address

7974 WAGGONER RUN DR
BLACKLICK OH
43004-9017
US

V. Phone/Fax

Practice location:
  • Phone: 614-325-2179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberRM294205
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: