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NPI Code Detail

MEDICARE: MS. HEATHER SLOANE TOLBERT CRNA

MEDICARE: MS. HEATHER SLOANE TOLBERT CRNA
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
1367500000XCertified Registered Nurse Anesthetist609892TX

General Provider Information

NPI Number : 1639156821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER SLOANE TOLBERT CRNA
Provider Business Mailing Address
First Line : 13601 PRESTON RD
Second Line : SUITE 900W
City : DALLAS
State : TX
Zip : 75240-4911
Country : US
Telephone Number : 972-233-1999
Fax Number : 972-386-4292
Provider Business Practice Location Address
First Line : 1301 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2122
Country : US
Telephone Number : 817-882-3680
Fax Number : 817-878-5135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 07/09/2007

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