MEDICARE: HEATHER DEE NEGOSLAWSKI APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1101438	TX

General Provider Information

NPI Number	:	1417669193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER DEE NEGOSLAWSKI APRN

Provider Business Mailing Address
First Line	:	1400 N COIT RD STE 601
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6658
Country	:	US
Telephone Number	:	664-678-4458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 N COIT RD STE 601
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6658
Country	:	US
Telephone Number	:	469-678-4458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	08/18/2024

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