Provider Demographics
NPI:1750501748
Name:HERNANDEZ-HEELEY, ROSA VELIA (RN, BSN, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:VELIA
Last Name:HERNANDEZ-HEELEY
Suffix:
Gender:F
Credentials:RN, BSN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13415 N 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1381
Mailing Address - Country:US
Mailing Address - Phone:602-843-2426
Mailing Address - Fax:
Practice Address - Street 1:455 N MESA DR STE 11
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5936
Practice Address - Country:US
Practice Address - Phone:480-844-4702
Practice Address - Fax:480-461-6456
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-054417363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology