Healthcare Provider Details

I. General information

NPI: 1669304747
Provider Name (Legal Business Name): HEATHER ANN BENDURE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WADSWORTH RD
WADSWORTH OH
44281-9580
US

IV. Provider business mailing address

5352 SUMMIT RD
LYNDHURST OH
44124-2816
US

V. Phone/Fax

Practice location:
  • Phone: 234-217-8882
  • Fax:
Mailing address:
  • Phone: 814-240-9232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: