Provider Demographics
NPI:1124260955
Name:PAVLOVSKI, HEATHER HELEN (RN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:HELEN
Last Name:PAVLOVSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 STANHOPE KELLOGGSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44003-9607
Mailing Address - Country:US
Mailing Address - Phone:440-645-9140
Mailing Address - Fax:
Practice Address - Street 1:5307 STANHOPE KELLOGGSVILLE RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9607
Practice Address - Country:US
Practice Address - Phone:440-645-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 319769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse