Healthcare Provider Details

I. General information

NPI: 1457930794
Provider Name (Legal Business Name): HEATHER ANN HARVEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 N 40TH ST STE 216
PHOENIX AZ
85032-3354
US

IV. Provider business mailing address

16601 N 40TH ST STE 216
PHOENIX AZ
85032-3354
US

V. Phone/Fax

Practice location:
  • Phone: 602-980-2164
  • Fax:
Mailing address:
  • Phone: 602-980-2164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number334806
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: