Provider Demographics
NPI:1245192400
Name:IGLESIA, HEATHER L (LPN)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
Last Name:IGLESIA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 GARDNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9385
Mailing Address - Country:US
Mailing Address - Phone:513-628-3628
Mailing Address - Fax:513-628-3628
Practice Address - Street 1:2285 GARDNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9385
Practice Address - Country:US
Practice Address - Phone:513-628-3628
Practice Address - Fax:513-628-3628
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH109081164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty