Heavenly Health Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEAVENLY HEALTH INC

Doing business as

Heavenly Health FNP

Practice address

308 East Hill Avenue
Gallup, NM 87301

Phone

(505) 722-6770

Fax

(505) 722-6799

NPI assigned

Dec 12, 2006

Last updated

Nov 8, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Georges Duval, MD

Title

Vice President

Phone

(505) 722-6770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HEAVENLY HEALTH FNP Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1427118926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 EAST HILL AVENUE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-6770",
            "fax_number": "505-722-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 EAST HILL AVENUE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-6770",
            "fax_number": "505-722-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "GEORGES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "505-722-6770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S9269",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEAVENLY HEALTH FNP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Brittnie Hearitige
• Jason Leonard Hefner, RN
• Martha Heinsohn
• Tabitha Darlene Heird, RN
• Frederic William Held, M.D.
• Davis E Henderson

• Family Medicine Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.