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General NPI Number Information
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NPI Number | 1629400544
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Entity Type | Individual
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Provider Name | HEATHER MUDD APRN
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Gender | Female
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | FSU UNIVERSITY HEALTH SERVICES 960 LEARNING WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32306-3426
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Country | US
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Telephone | 850-209-5880
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Fax | 850-644-4251
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Provider Business Mailing Address
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Address Line | 4914 HERITAGE PARK BLVD
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City | TALLAHASSEE
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State | FL
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Zip | 32311-1214
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Country | US
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Telephone | 850-443-1822
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Fax | 850-644-4251
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9365905
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License Number State | FL
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