Shoup, Heather M

Shoup, Heather M is an sole proprietor health care provider with primary practice located at 2350 Miami Valley Dr Ste 500 , Dayton OH 45459-4780. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Shoup, Heather M can be contacted via phone (937) 293-1622.

Contact Information

Primary practice address
2350 Miami Valley Dr Ste 500 Dayton OH 45459-4780
Phone: (937) 293-1622
Fax: (937) 245-6308
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN317714 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X COA16815NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN.CNP.16815 Ohio

Profile Details

NPI number 1407251523
LBN Legal business name Shoup, Heather M
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2014
Last updated Jan 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407251523 NPPES
Ohio MEDICAID 0113882

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