Provider Demographics
NPI:1942093778
Name:INLUXAY, HEATHER JEAN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JEAN
Last Name:INLUXAY
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 1:4918 ROUTE 98
Mailing Address - Street 2:
Mailing Address - City:NORTH JAVA
Mailing Address - State:NY
Mailing Address - Zip Code:14113-9754
Mailing Address - Country:US
Mailing Address - Phone:716-536-2850
Mailing Address - Fax:
Practice Address - Street 1:4918 ROUTE 98
Practice Address - Street 2:
Practice Address - City:NORTH JAVA
Practice Address - State:NY
Practice Address - Zip Code:14113-9754
Practice Address - Country:US
Practice Address - Phone:176-536-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275559164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse