Healthcare Provider Details

I. General information

NPI: 1073858338
Provider Name (Legal Business Name): HEATHER LYNNE HURFORD RN, MSN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SOUTH FWY
FORT WORTH TX
76115-1400
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 817-750-7334
  • Fax: 210-314-5044
Mailing address:
  • Phone: 682-885-6163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number743287
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP122617
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP122617
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: