Provider Demographics
NPI:1962200782
Name:PACHASA, HEATHER
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PACHASA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 E STATE ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:OH
Mailing Address - Zip Code:44867-8902
Mailing Address - Country:US
Mailing Address - Phone:419-208-3938
Mailing Address - Fax:
Practice Address - Street 1:6670 E STATE ROUTE 19
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:OH
Practice Address - Zip Code:44867-8902
Practice Address - Country:US
Practice Address - Phone:419-208-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide