Provider Demographics
NPI:1942970231
Name:AL-SAHLANI, HEBA MAZIN (PA-C)
Entity type:Individual
Prefix:
First Name:HEBA
Middle Name:MAZIN
Last Name:AL-SAHLANI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E WILLETTA ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2528
Mailing Address - Country:US
Mailing Address - Phone:602-839-6900
Mailing Address - Fax:
Practice Address - Street 1:901 E WILLETTA ST FL 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2528
Practice Address - Country:US
Practice Address - Phone:602-839-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
PAMA062992363A00000X
PAOA005859363A00000X
NC0010-11818363A00000X
AZ11012363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
15449281OtherCAQH