Provider Demographics
NPI:1871266585
Name:TRUJILLO, HEATHER ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 W VILLA HERMOSA
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4380
Mailing Address - Country:US
Mailing Address - Phone:623-202-2806
Mailing Address - Fax:
Practice Address - Street 1:14300 W GRANITE VALLEY DR STE D17
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5798
Practice Address - Country:US
Practice Address - Phone:623-887-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily