Healthcare Provider Details

I. General information

NPI: 1629840012
Provider Name (Legal Business Name): HEATHER MARIE RITTER APRN, AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CAMDEN ST STE 108
SAN ANTONIO TX
78215-2100
US

IV. Provider business mailing address

2118 PECAN HVN
NEW BRAUNFELS TX
78130-2769
US

V. Phone/Fax

Practice location:
  • Phone: 210-253-3426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1140626
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1140626
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1140626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: