1285114140 NPI number — MRS. HEATHER CHRISTINE ROBINSON R.N.

Table of content: MRS. HEATHER CHRISTINE ROBINSON R.N. (NPI 1285114140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285114140 NPI number — MRS. HEATHER CHRISTINE ROBINSON R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
HEATHER
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CREACH
Provider Other First Name:
HEATHER
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285114140
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30009 N SUNRISE PT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85383-7873
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-773-6504
Provider Business Mailing Address Fax Number:
623-773-6507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30009 N SUNRISE PT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85383-7873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-773-6504
Provider Business Practice Location Address Fax Number:
623-773-6507
Provider Enumeration Date:
08/20/2018

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: 163WS0200X , with the licence number:  RN164507 , 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)





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