Healthcare Provider Details

I. General information

NPI: 1295834778
Provider Name (Legal Business Name): LENNARD SCOT HEY D.C., FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 MCHENRY AVE SUITE F
MODESTO CA
95350-3259
US

IV. Provider business mailing address

2501 MCHENRY AVE SUITE F
MODESTO CA
95350-3259
US

V. Phone/Fax

Practice location:
  • Phone: 209-522-9054
  • Fax: 209-522-2631
Mailing address:
  • Phone: 209-522-9054
  • Fax: 209-522-2631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95002817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: