Provider Demographics
NPI:1699532465
Name:GIERISH, HEATHER (APRN-RNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GIERISH
Suffix:
Gender:F
Credentials:APRN-RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10065 W PATRICK LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2891
Mailing Address - Country:US
Mailing Address - Phone:602-448-4279
Mailing Address - Fax:
Practice Address - Street 1:15351 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4580
Practice Address - Country:US
Practice Address - Phone:480-964-2273
Practice Address - Fax:623-440-1485
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ304525363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health