Kimberley Heatwole

Individual provider Active NPI Registered Nurse First Assistant · Page, AZ

NPI 1730890989 · NPPES record last updated Dec 8, 2022

Key facts

NPI
1730890989
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse First Assistant 163WR0006X
License
RN126339 (AZ)
Practice address
501 N Navajo Dr
Page, AZ 86040-0959
Phone
(928) 645-0165
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN126339AZMDRegistered Nurse First Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN126339 AZ Yes

Addresses

Primary practice location

501 N Navajo Dr
Page, AZ 86040-0959

Mailing address

PO Box 7182
Page, AZ 86040-7182
Phone (928) 640-7454

Other providers in Page, AZ

All providers in Page, AZ · Registered Nurse First Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.