MEDICARE: MRS. LORI MURIEL HEINZMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	2305484	OH
2	372600000X	Adult Companion	2305484	OH

General Provider Information

NPI Number	:	1093302440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI MURIEL HEINZMAN

Provider Business Mailing Address
First Line	:	443 W HUBERT AVE
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-4717
Country	:	US
Telephone Number	:	740-407-5078
Fax Number	:

Provider Business Practice Location Address
First Line	:	2652 KULL RD
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-7707
Country	:	US
Telephone Number	:	740-687-0835
Fax Number	:	740-687-9313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	02/20/2026

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