MEDICARE: CANDICE HEABERLIN

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

General Provider Information

NPI Number	:	1992561393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE HEABERLIN

Provider Business Mailing Address
First Line	:	7477 GREENFARMS DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1209
Country	:	US
Telephone Number	:	614-517-3814
Fax Number	:

Provider Business Practice Location Address
First Line	:	7477 GREENFARMS DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1209
Country	:	US
Telephone Number	:	614-517-3814
Fax Number	:

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

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	04/23/2026

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Directions to “ CANDICE HEABERLIN ” Practice Location

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