Healthcare Provider Details

I. General information

NPI: 1255987012
Provider Name (Legal Business Name): HEATHER RENEE WESTMORELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 W CHURCH ST STE 318
NEWARK OH
43055-5050
US

IV. Provider business mailing address

6635 SOUTHERN VISTA DR
ENON OH
45323-1640
US

V. Phone/Fax

Practice location:
  • Phone: 740-281-1777
  • Fax:
Mailing address:
  • Phone: 937-543-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2411568
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: