1720690837 NPI number — ROBERT LAWRENCE HEINZE DNP, APRN-RNP, ACNPC

Table of content: ROBERT LAWRENCE HEINZE DNP, APRN-RNP, ACNPC (NPI 1720690837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720690837 NPI number — ROBERT LAWRENCE HEINZE DNP, APRN-RNP, ACNPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEINZE
Provider First Name:
ROBERT
Provider Middle Name:
LAWRENCE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN-RNP, ACNPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720690837
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6423
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85246-6423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-245-6286
Provider Business Mailing Address Fax Number:
480-398-8070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6111 E ARBOR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85206-6059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-981-1326
Provider Business Practice Location Address Fax Number:
480-981-1445
Provider Enumeration Date:
08/19/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  295273 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com