Healthcare Provider Details

I. General information

NPI: 1427457811
Provider Name (Legal Business Name): CONNIE HEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

5360 CLEVES WARSAW PIKE
CINCINNATI OH
45238-3602
US

V. Phone/Fax

Practice location:
  • Phone: 513-487-6704
  • Fax:
Mailing address:
  • Phone: 513-290-2115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.225695
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: