Provider Demographics
NPI:1063756674
Name:GABAREE, HEATHER KATHRYN (RN, BSN, MSN, PNP-AC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHRYN
Last Name:GABAREE
Suffix:
Gender:F
Credentials:RN, BSN, MSN, PNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4947
Mailing Address - Country:US
Mailing Address - Phone:480-495-2911
Mailing Address - Fax:
Practice Address - Street 1:1430 N COOPER RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1242
Practice Address - Country:US
Practice Address - Phone:480-633-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4761363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care