Heather Agemik, RN
Individual provider Active NPI Registered Nurse · Mentor, OH
NPI 1780325852 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1780325852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN.355922 (OH)
- Practice address
- 7232 Justin Way
Mentor, OH 44060-4881 - Phone
- (440) 578-8200
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.355922 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | RN.355922 | OH | Yes |
Addresses
Primary practice location
7232 Justin Way
Mentor, OH 44060-4881
Mailing address
7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200
Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.