Provider Demographics
NPI:1366204992
Name:LESPERANCE, HEIDI SUE
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:SUE
Last Name:LESPERANCE
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 1:1210 E 21ST ST APT 401
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4020
Mailing Address - Country:US
Mailing Address - Phone:440-228-2890
Mailing Address - Fax:
Practice Address - Street 1:1210 E 21ST ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4019
Practice Address - Country:US
Practice Address - Phone:440-228-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRS135088374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty