Healthcare Provider Details

I. General information

NPI: 1255203204
Provider Name (Legal Business Name): HEATHER SIMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 10/24/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 S ARROYA RD
APACHE JUNCTION AZ
85119-9679
US

IV. Provider business mailing address

265 S ARROYA RD
APACHE JUNCTION AZ
85119-9679
US

V. Phone/Fax

Practice location:
  • Phone: 480-323-8942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberPMH08250062
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: