Provider Demographics
NPI:1902809072
Name:ERPELDING, HEIDI (PT)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:ERPELDING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32490
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-2490
Mailing Address - Country:US
Mailing Address - Phone:602-230-4478
Mailing Address - Fax:602-230-9962
Practice Address - Street 1:18275 N 59TH AVE
Practice Address - Street 2:BLDG K-164
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1260
Practice Address - Country:US
Practice Address - Phone:602-588-0320
Practice Address - Fax:602-588-0325
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ117730Medicaid
AZ117730Medicaid
AZZ78929Medicare PIN