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NPI Code Detail

MEDICARE: HEATHER GERALD PA-C

MEDICARE: HEATHER GERALD PA-C
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
1363AS0400XSurgical Physician Assistant11321AZ
2363A00000XPhysician Assistant11321AZ

General Provider Information

NPI Number : 1780490490
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER GERALD PA-C
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 1955 W FRYE RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6282
Country : US
Telephone Number : 480-728-3000
Fax Number : 480-728-4747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2024
Last Update Date : 06/08/2026

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Directions to “ HEATHER GERALD PA-C” Practice Location

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