Basic Information
Provider Information
NPI: 1518213016
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CERO
FirstName: HEATHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CLAPP
OtherFirstName: HEATHER
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 8333 NAAB RD
Address2: SUITE 250
City: INDIANAPOLIS
State: IN
PostalCode: 462605924
CountryCode: US
TelephoneNumber: 3173961300
FaxNumber: 3173961346
Practice Location
Address1: 355 W 16TH ST
Address2: SUITE 5100
City: INDIANAPOLIS
State: IN
PostalCode: 462022207
CountryCode: US
TelephoneNumber: 3173961300
FaxNumber: 3173961267
Other Information
ProviderEnumerationDate: 08/02/2012
LastUpdateDate: 09/26/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X28129065AINY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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