Provider Demographics
NPI:1053035055
Name:HEED, CHRISTINE MARIE
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:HEED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5162 GLENMOORE WAY
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6838
Mailing Address - Country:US
Mailing Address - Phone:216-544-0684
Mailing Address - Fax:
Practice Address - Street 1:5162 GLENMOORE WAY
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-6838
Practice Address - Country:US
Practice Address - Phone:216-544-0684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No347C00000XTransportation ServicesPrivate Vehicle