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NPI Code Detail

MEDICARE: HEATHER FYDRYCH

MEDICARE: HEATHER FYDRYCH
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
1363LP0200XPediatric Nurse Practitioner231777AZ
2163W00000XRegistered NurseRN179988AZ

General Provider Information

NPI Number : 1255890737
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER FYDRYCH
Provider Business Mailing Address
First Line : 1625 N CAMPBELL AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-4330
Country : US
Telephone Number : 520-694-3325
Fax Number :
Provider Business Practice Location Address
First Line : 1625 N CAMPBELL AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-4330
Country : US
Telephone Number : 520-694-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2019
Last Update Date : 02/10/2026

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Directions to “ HEATHER FYDRYCH ” Practice Location

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