Healthcare Provider Details

I. General information

NPI: 1780502195
Provider Name (Legal Business Name): HEIDI MCINTOSH MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38095 STATE ROUTE 39
SALINEVILLE OH
43945-9726
US

IV. Provider business mailing address

38095 STATE ROUTE 39
SALINEVILLE OH
43945-9726
US

V. Phone/Fax

Practice location:
  • Phone: 330-679-2343
  • Fax: 330-679-3005
Mailing address:
  • Phone: 330-679-2343
  • Fax: 330-679-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN233551
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: