Provider Demographics
NPI:1235462185
Name:BLOCK, HEIDI CRAIG (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:CRAIG
Last Name:BLOCK
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6018
Mailing Address - Country:US
Mailing Address - Phone:480-484-3520
Mailing Address - Fax:480-484-3501
Practice Address - Street 1:4610 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6018
Practice Address - Country:US
Practice Address - Phone:480-484-3520
Practice Address - Fax:480-484-3501
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN081227163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool