Provider Demographics
NPI:1538824800
Name:CIROULA, HEATHER LYNNE (BSRN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE
Last Name:CIROULA
Suffix:
Gender:F
Credentials:BSRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-3661
Mailing Address - Country:US
Mailing Address - Phone:585-615-0013
Mailing Address - Fax:
Practice Address - Street 1:33 DEEPWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-3661
Practice Address - Country:US
Practice Address - Phone:585-615-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY507670-01163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health