Healthcare Provider Details

I. General information

NPI: 1245130046
Provider Name (Legal Business Name): HEATHER HERRING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3956 E GERONIMO ST
GILBERT AZ
85295-2777
US

IV. Provider business mailing address

3956 E GERONIMO ST
GILBERT AZ
85295-2777
US

V. Phone/Fax

Practice location:
  • Phone: 248-802-4895
  • Fax:
Mailing address:
  • Phone: 248-802-4895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: