Provider Demographics
NPI:1346408754
Name:JARRELL, HEATHER SUMNER (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:SUMNER
Last Name:JARRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:MSC07 4040
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-1438
Mailing Address - Country:US
Mailing Address - Phone:505-272-3053
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:MSC07 4040
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-3053
Practice Address - Fax:505-925-0546
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2014-0533207ZF0201X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology