Heasman, Annette Jo

Heasman, Annette Jo is an individual health care provider with primary practice located at 4636 N 40Th St , Phoenix AZ 85018-3623. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Heasman, Annette Jo can be contacted via phone (602) 355-6668.

Contact Information

Primary practice address
4636 N 40Th St Phoenix AZ 85018-3623
Phone: (602) 355-6668
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X RN017555 Arizona

Profile Details

NPI number 1215050562
LBN Legal business name Heasman, Annette Jo
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215050562 NPPES
Arizona MEDICAID 568917

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