Provider Demographics
NPI:1932304839
Name:STEVENS, HEATHER L (MD)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W. WYATT DR.
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-545-0608
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:6261 N LA CHOLLA BLVD STE 277
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3564
Practice Address - Country:US
Practice Address - Phone:520-877-3800
Practice Address - Fax:520-877-3801
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106982207V00000X
AZ47645207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003986300Medicaid
AZ857445Medicaid
AZ857445Medicaid
FLFI960ZMedicare PIN