=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528859956
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING HEART CONNECTIONS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2025
-----------------------------------------------------
Last Update Date | 05/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1222 SE 47TH ST STE 112
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33904-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-448-5959
-----------------------------------------------------
Fax | 239-946-0232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1222 SE 47TH ST STE 112
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33904-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-448-5959
-----------------------------------------------------
Fax | 239-946-0232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JUDITH ANN WALTERS
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 239-314-6417
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SP0809X
-----------------------------------------------------
Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------