Provider Demographics
NPI:1528478419
Name:HECKEL, GEOFFREY JAMES (FNP, DNP, APRN)
Entity type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:JAMES
Last Name:HECKEL
Suffix:
Gender:M
Credentials:FNP, DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 S 5600 W
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-1249
Mailing Address - Country:US
Mailing Address - Phone:801-417-5734
Mailing Address - Fax:
Practice Address - Street 1:2750 S 5600 W
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-1249
Practice Address - Country:US
Practice Address - Phone:801-417-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4868524-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily