Provider Demographics
NPI:1275350373
Name:DEAN, HEATHER ANNE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:DEAN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75652-3327
Mailing Address - Country:US
Mailing Address - Phone:817-681-2667
Mailing Address - Fax:
Practice Address - Street 1:703 E MARSHALL AVE STE 4002
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5622
Practice Address - Country:US
Practice Address - Phone:903-315-3966
Practice Address - Fax:903-230-0795
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily