Basic Information
| Provider Information | |||||||||
| NPI: | 1982988127 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOLES | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | LIN | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7691 5 MILE RD | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452304348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136247246 | ||||||||
| FaxNumber: | 5136246900 | ||||||||
| Practice Location | |||||||||
| Address1: | 7691 5 MILE RD | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452304348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136247246 | ||||||||
| FaxNumber: | 5136246900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2011 | ||||||||
| LastUpdateDate: | 10/06/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 12762 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.