Provider Demographics
NPI:1821512195
Name:WEISZHAAR, HEATHER MARY (NP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARY
Last Name:WEISZHAAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 E SAHUARO DR APT 2071
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5298
Mailing Address - Country:US
Mailing Address - Phone:605-212-6200
Mailing Address - Fax:
Practice Address - Street 1:8841 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1535
Practice Address - Country:US
Practice Address - Phone:480-719-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F1016976OtherAANP
AZAP10279OtherAZ STATE BOARD OF NURSING