Healthcare Provider Details

I. General information

NPI: 1720243793
Provider Name (Legal Business Name): HEATHER KIRSTEN BALLARD DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37555 N. CAVE CREEK RD.
CAVE CREEK AZ
85327
US

IV. Provider business mailing address

1012 W LAS PALMARITAS DR
PHOENIX AZ
85021-5549
US

V. Phone/Fax

Practice location:
  • Phone: 480-488-6181
  • Fax:
Mailing address:
  • Phone: 602-296-7374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number4142
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: