Healthcare Provider Details
I. General information
NPI: 1205697067
Provider Name (Legal Business Name): HEATHER VASCASSENNO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/18/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1169 ROBERTSON RD S
MURRAY KY
42071-4649
US
IV. Provider business mailing address
8911 N CAPITAL OF TEXAS HWY BLDG 1
AUSTIN TX
78759-7247
US
V. Phone/Fax
- Phone: 270-544-0756
- Fax:
- Phone: 877-279-5960
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 39903 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 4060579 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: