Provider Demographics
NPI:1942936646
Name:PLANCK, HEATHER KAY
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KAY
Last Name:PLANCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 BRIAN RD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-7331
Mailing Address - Country:US
Mailing Address - Phone:303-882-6740
Mailing Address - Fax:
Practice Address - Street 1:1051 BRIAN RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-7331
Practice Address - Country:US
Practice Address - Phone:303-882-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant