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General NPI Number Information
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NPI Number | 1780379859
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Entity Type | Individual
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Provider Name | HEATHER LYNN SPENGLER PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 4016 GATEWAY DR STE 120
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5960
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Country | US
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Telephone | 817-283-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 6021 AIMSLEY CT APT 615
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City | FT WORTH
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State | TX
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Zip | 76137-8046
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Country | US
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Telephone | 217-855-0659
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1107529
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License Number State | TX
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