Provider Demographics
NPI:1679779441
Name:HANLEY, HEATHER ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANNE
Last Name:HANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-933-1784
Mailing Address - Fax:602-933-1785
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-1874
Practice Address - Fax:602-933-1875
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2015-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ508182080P0203X
CAA1048582080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine