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NPI Code Detail

MEDICARE: HEIDI PENCE APRN

MEDICARE: HEIDI PENCE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN-087676AZ

General Provider Information

NPI Number : 1245330224
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI PENCE APRN
Provider Business Mailing Address
First Line : 6380 EAST THOMAS ROAD
Second Line : SUITE 235
City : SCOTTSDALE
State : AZ
Zip : 85251
Country : US
Telephone Number : 480-949-1100
Fax Number : 480-949-1150
Provider Business Practice Location Address
First Line : 1037 E MISSOURI AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2663
Country : US
Telephone Number : 602-393-2373
Fax Number : 602-393-2374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 04/09/2008

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Directions to “ HEIDI PENCE APRN” Practice Location

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