Healthcare Provider Details

I. General information

NPI: 1467602276
Provider Name (Legal Business Name): CHRISTOPHER JOHN HEATHER RN, CNS, APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975-A KINGSVIEW DR.
LEBANON OH
45036
US

IV. Provider business mailing address

5657 KLAUSRIDGE CT
CINCINNATI OH
45247-5998
US

V. Phone/Fax

Practice location:
  • Phone: 513-228-7800
  • Fax:
Mailing address:
  • Phone: 513-574-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-10095
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: