Provider Demographics
NPI:1780130211
Name:ANNEST, HEIDI (RN)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:ANNEST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 E HOWE AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-4818
Mailing Address - Country:US
Mailing Address - Phone:480-894-5574
Mailing Address - Fax:480-894-2755
Practice Address - Street 1:2130 E HOWE AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-4818
Practice Address - Country:US
Practice Address - Phone:480-894-5574
Practice Address - Fax:480-894-2755
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN 198445163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool