Healthcare Provider Details

I. General information

NPI: 1316783897
Provider Name (Legal Business Name): HEATHER MUENCH DNP, APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 235
PHOENIX AZ
85037-3363
US

IV. Provider business mailing address

10460 N 92ND ST STE 300
SCOTTSDALE AZ
85258-4547
US

V. Phone/Fax

Practice location:
  • Phone: 623-327-4100
  • Fax:
Mailing address:
  • Phone: 480-323-1573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308448
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number308448
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number308448
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number308448
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: