Individual
HEATHER WAGHELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 589, FORT DEFIANCE, AZ 86504-8649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
216266
AK
363LA2100X
Acute Care Nurse Practitioner
Primary
430756
NY
363LF0000X
Family Nurse Practitioner
Primary
216266
AK
363LG0600X
Gerontology Nurse Practitioner
216266
AK
Other
Enumeration date
09/06/2013
Last updated
05/21/2026
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