Provider Demographics
NPI:1265249437
Name:REGAN, HEATHER ELAINE (RRT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELAINE
Last Name:REGAN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11671 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-4985
Mailing Address - Country:US
Mailing Address - Phone:309-716-4473
Mailing Address - Fax:
Practice Address - Street 1:1200 W MOHAVE RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-6349
Practice Address - Country:US
Practice Address - Phone:928-669-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0228592279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care