Healthcare Provider Details

I. General information

NPI: 1508987827
Provider Name (Legal Business Name): HEART HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S WHITE MOUNTAIN RD SUITE 201
SHOW LOW AZ
85901-7111
US

IV. Provider business mailing address

PO BOX 2725
SHOW LOW AZ
85902-2725
US

V. Phone/Fax

Practice location:
  • Phone: 928-532-5835
  • Fax:
Mailing address:
  • Phone: 928-532-5835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN027294
License Number StateAZ

VIII. Authorized Official

Name: FRAN STIER
Title or Position: OWNER
Credential: NP
Phone: 928-532-5835