HEATHER KILLAM NP NPI 1114914967

NPI Information

NPI: 1114914967
Provider Name: HEATHER KILLAM, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: RAGHAV LLC

PECOS Registration: Yes

Address:
12361 W BOLA DR STE 109
SURPRISE, AZ
ZIP 85378
Phone: (623) 227-1000
Get Directions

Heather Killam, NP is a family nurse practitioner in Surprise, AZ with 20 years of experience. Heather Killam, NP NPI is 1114914967. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12361 W BOLA DR STE 109
SURPRISE, AZ
ZIP 85378-021
Phone: (623) 227-1000
Fax: (623) 227-2000

The NPI 1114914967 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/5/2005 and was last updated on 2/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN115515	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	907157	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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