Healthcare Provider Details

I. General information

NPI: 1326169657
Provider Name (Legal Business Name): HEIDI S ALESSI RN FNP C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 N WINDSONG DR
PRESCOTT VALLEY AZ
86314-2248
US

IV. Provider business mailing address

3051 N WINDSONG DR
PRESCOTT VALLEY AZ
86314-2248
US

V. Phone/Fax

Practice location:
  • Phone: 928-772-3336
  • Fax: 928-775-0021
Mailing address:
  • Phone: 928-772-3336
  • Fax: 928-775-0021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN093850
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2615
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: