MEDICARE: HEATHER MAURA ROSS ANP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN127376	AZ
2	363LA2200X	Adult Health Nurse Practitioner	AP1917	AZ

General Provider Information

NPI Number	:	1366607525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MAURA ROSS ANP-BC

Provider Business Mailing Address
First Line	:	5436 E CHERYL DR
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-1100
Country	:	US
Telephone Number	:	480-993-6081
Fax Number	:	775-370-7971

Provider Business Practice Location Address
First Line	:	3225 N CIVIC CENTER PLZ
Second Line	:	SUITE1
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-6919
Country	:	US
Telephone Number	:	480-246-3000
Fax Number	:	480-246-3100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2008
Last Update Date	:	08/11/2014

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Directions to “ HEATHER MAURA ROSS ANP-BC” Practice Location

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