Provider Demographics
NPI:1720243793
Name:BALLARD, HEATHER KIRSTEN (DVM)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:KIRSTEN
Last Name:BALLARD
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 W LAS PALMARITAS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5549
Mailing Address - Country:US
Mailing Address - Phone:602-296-7374
Mailing Address - Fax:
Practice Address - Street 1:37555 N. CAVE CREEK RD.
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85327
Practice Address - Country:US
Practice Address - Phone:480-488-6181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4142174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian