Provider Demographics
NPI:1316185580
Name:GIRK, HEATHER (ARNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GIRK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7718
Mailing Address - Country:US
Mailing Address - Phone:941-365-1277
Mailing Address - Fax:941-366-1849
Practice Address - Street 1:720 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7718
Practice Address - Country:US
Practice Address - Phone:941-365-1277
Practice Address - Fax:941-366-1849
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3061442363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306544800Medicaid