| Healthy Heritage Family Care, Llc. | |
|
40 W Brown Rd Ste 109 Mesa AZ 85201-3446 | |
| (480) 347-7195 | |
| Not Available |
| Full Name | Healthy Heritage Family Care, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 40 W Brown Rd Ste 109, Mesa, Arizona |
| Authorized Official Name and Position | Nancy Lynn Mitchell (OWNER) |
| Authorized Official Contact | 4802412252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Heritage Family Care, Llc. 40 W Brown Rd Ste 109 Mesa AZ 85201-3446 Ph: (480) 347-7195 | Healthy Heritage Family Care, Llc. 40 W Brown Rd Ste 109 Mesa AZ 85201-3446 Ph: (480) 347-7195 |
| NPI Number | 1063188118 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 11/18/2021 |
| Medicare PECOS PAC ID | 3173920287 |
|---|---|
| Medicare Enrollment ID | O20210927001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063188118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nancy Lynn Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043823800 PECOS PAC ID: 4082011192 Enrollment ID: I20211118002694 |
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