Killam, Heather

Killam, Heather is an individual health care provider with primary practice located at 12361 W Bola Dr Ste 109 , Surprise AZ 85378-9021. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Killam, Heather can be contacted via phone (623) 227-1000.

Contact Information

Primary practice address
12361 W Bola Dr Ste 109 Surprise AZ 85378-9021
Phone: (623) 227-1000
Fax: (623) 227-2000
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN115515 Arizona

Profile Details

NPI number 1114914967
LBN Legal business name Killam, Heather
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Feb 1st, 2020 - about 5 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 1114914967 NPPES
Arizona MEDICAID 907157

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