Provider Demographics
NPI:1114759735
Name:KEEFER, HEATHER MARIE (DSP)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MARIE
Last Name:KEEFER
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2276 RABER RD APT F
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8811
Mailing Address - Country:US
Mailing Address - Phone:234-458-4377
Mailing Address - Fax:
Practice Address - Street 1:2276 RABER RD APT F
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8811
Practice Address - Country:US
Practice Address - Phone:234-458-4377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
347C00000X
OHRW860970343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle