Healthcare Provider Details

I. General information

NPI: 1912472457
Provider Name (Legal Business Name): KATLIN HEHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATLIN SANDERS

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 GOOD SAMARITAN DR STE A
CINCINNATI OH
45247-5209
US

IV. Provider business mailing address

7691 5 MILE RD STE 10
CINCINNATI OH
45230-4348
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7733
  • Fax: 513-852-8719
Mailing address:
  • Phone: 513-624-7246
  • Fax: 937-949-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF10180357
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.023752
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: