Healthcare Provider Details

I. General information

NPI: 1992158299
Provider Name (Legal Business Name): COURTNEY HECK CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5407 WALZEM RD
WINDCREST TX
78218-2126
US

IV. Provider business mailing address

1221 ALGARITA AVE APT 268
AUSTIN TX
78704-4416
US

V. Phone/Fax

Practice location:
  • Phone: 210-646-8833
  • Fax:
Mailing address:
  • Phone: 858-722-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP133913
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: