MEDICARE: MS. PATRICIA ANN HEEBSH CNP

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	363LA2100X	Acute Care Nurse Practitioner	APRN.CNP.021156	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720501521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN HEEBSH CNP

Provider Business Mailing Address
First Line	:	1 WYOMING ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45409-2722
Country	:	US
Telephone Number	:	937-477-1930
Fax Number	:

Provider Business Practice Location Address
First Line	:	5338 PHILADELPHIA DR
Second Line	:	SUITE B
City	:	DAYTON
State	:	OH
Zip	:	45415-3061
Country	:	US
Telephone Number	:	937-424-3589
Fax Number	:	937-424-0093

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

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	11/21/2023

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