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General NPI Number Information
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NPI Number | 1336243351
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Entity Type | Individual
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Provider Name | HEATHER HOLLAND SKRIVANEK PHD, CPNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 560 N KIMBALL AVE STE 130
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6879
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Country | US
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Telephone | 817-899-8485
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Fax | 817-977-9025
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Provider Business Mailing Address
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Address Line | 560 N KIMBALL AVE STE 130
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6879
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Country | US
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Telephone | 817-899-8485
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Fax | 817-977-9025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP113941
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 113941
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License Number State | TX
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