Healthcare Provider Details

I. General information

NPI: 1386630333
Provider Name (Legal Business Name): HEATHER LYNN CAUDELL RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W MAIN ST
LEWISVILLE TX
75057-3866
US

IV. Provider business mailing address

328 W MAIN ST
LEWISVILLE TX
75057-3866
US

V. Phone/Fax

Practice location:
  • Phone: 972-436-7557
  • Fax: 972-221-8246
Mailing address:
  • Phone: 972-436-7557
  • Fax: 972-221-8246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: