Provider Demographics
NPI:1003998063
Name:JANKOWSKI, HEATHER (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JANKOWSKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-4100
Mailing Address - Fax:
Practice Address - Street 1:1400 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4498
Practice Address - Country:US
Practice Address - Phone:520-324-5090
Practice Address - Fax:520-324-5236
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ908551Medicaid