Provider Demographics
NPI:1356344238
Name:PISLE, HEATHER M (CNM)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:M
Last Name:PISLE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W HIGH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3968
Mailing Address - Country:US
Mailing Address - Phone:419-227-0610
Mailing Address - Fax:419-228-3273
Practice Address - Street 1:830 W HIGH ST
Practice Address - Street 2:STE 101
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3968
Practice Address - Country:US
Practice Address - Phone:419-227-0610
Practice Address - Fax:419-228-3273
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM-00987367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife