Healthcare Provider Details

I. General information

NPI: 1154948800
Provider Name (Legal Business Name): CHRISTINA MARIE HEIKEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234
US

IV. Provider business mailing address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 623-624-8280
  • Fax: 602-835-0192
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number243390
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: