Provider Demographics
NPI:1104536796
Name:CARLISLE, HEATHERENE HUGHES (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHERENE
Middle Name:HUGHES
Last Name:CARLISLE
Suffix:
Gender:
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 PRESKITT RD STE 600
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-4120
Mailing Address - Country:US
Mailing Address - Phone:940-626-8073
Mailing Address - Fax:
Practice Address - Street 1:902 PRESKITT RD STE 600
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4120
Practice Address - Country:US
Practice Address - Phone:940-626-8073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158233363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily