Provider Demographics
NPI:1508987827
Name:HEART HEALTH CARE LLC
Entity Type:Organization
Organization Name:HEART HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STIER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:928-532-5835
Mailing Address - Street 1:PO BOX 2725
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85902-2725
Mailing Address - Country:US
Mailing Address - Phone:928-532-5835
Mailing Address - Fax:
Practice Address - Street 1:1500 S WHITE MOUNTAIN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7111
Practice Address - Country:US
Practice Address - Phone:928-532-5835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN027294363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS52379Medicare UPIN
AZ115334Medicare PIN