MEDICARE: MRS. KATHERINE ELIZABETH HEYDE APRN, FNP-C

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	1001843	TX

General Provider Information

NPI Number	:	1649897067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE ELIZABETH HEYDE APRN, FNP-C

Provider Business Mailing Address
First Line	:	5056 TENNYSON PKWY STE 200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2922
Country	:	US
Telephone Number	:	972-372-9590
Fax Number	:

Provider Business Practice Location Address
First Line	:	5056 TENNYSON PKWY STE 200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2922
Country	:	US
Telephone Number	:	214-402-3566
Fax Number	:

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

Provider Enumeration Date	:	07/01/2020
Last Update Date	:	06/14/2022

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