Individual
KIMBERLEY HEATWOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N NAVAJO DR, PAGE, AZ 86040-0959
(928) 645-0165
Mailing address
PO BOX 7182, PAGE, AZ 86040-7182
(928) 640-7454
(928) 645-6663
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN126339
AZ
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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