1720085798 NPI number — TRUDY RUMANN HEIL MS, RN, FNP,COHN-S

Table of content: TRUDY RUMANN HEIL MS, RN, FNP,COHN-S (NPI 1720085798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720085798 NPI number — TRUDY RUMANN HEIL MS, RN, FNP,COHN-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEIL
Provider First Name:
TRUDY
Provider Middle Name:
RUMANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, RN, FNP,COHN-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720085798
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7349 N VIA PASEO DEL SUR
Provider Second Line Business Mailing Address:
SUITE 515-451
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85258-3749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-874-2900
Provider Business Mailing Address Fax Number:
480-874-2902

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7349 N VIA PASEO DEL SUR
Provider Second Line Business Practice Location Address:
SUITE 515-451
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258-3749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-874-2900
Provider Business Practice Location Address Fax Number:
480-874-2902
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN056661 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AP0213 . This is a "ADV PRAC CERTIFICATE NMBR" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: RN056661 . This is a "REGISTERED NURSE LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 65-1251664 . This is a "NP-PPA TAX ID" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0149310 . This is a "NON-CONTRACTED PROVIDER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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