Provider Demographics
NPI:1407525140
Name:HEAPS, SUSAN QUACH (APRN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:QUACH
Last Name:HEAPS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:QUACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:500 N RAINBOW BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1084
Mailing Address - Country:US
Mailing Address - Phone:702-259-1228
Mailing Address - Fax:702-259-1252
Practice Address - Street 1:6900 N DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4409
Practice Address - Country:US
Practice Address - Phone:702-835-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV841033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily