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NPI Code Detail

MEDICARE: MRS. HEATHER ANN MUXWORTHY DNP, PMHNP-BC

MEDICARE: MRS. HEATHER ANN MUXWORTHY DNP, PMHNP-BC
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
1101YM0800XMental Health CounselorF400539NY
2363LP0808XPsychiatric/Mental Health Nurse Practitioner397795NY
3363LP0808XPsychiatric/Mental Health Nurse PractitionerF400539-1NY

General Provider Information

NPI Number : 1417911256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER ANN MUXWORTHY DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 82 HOLLAND ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2131
Country : US
Telephone Number : 585-423-5800
Fax Number :
Provider Business Practice Location Address
First Line : 82 HOLLAND ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2131
Country : US
Telephone Number : 585-423-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 07/06/2023

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