Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 254221 | AZ |
NPI | 1306445002 |
---|---|
Provider Name | Sina Lee Heller |
First Address | Las Vegas, NV 89166-5172 |
Second Address | Phoenix, AZ 85006-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2020 |
Last Update Date | 22/03/2021 |