MEDICARE: HEATHER COLLIER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA2000X	Administrator Registered Nurse	706584	TX

General Provider Information

NPI Number	:	1033620547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER COLLIER RN

Provider Business Mailing Address
First Line	:	17314 STATE HIGHWAY 249 STE 230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-1140
Country	:	US
Telephone Number	:	832-895-3400
Fax Number	:	832-895-0293

Provider Business Practice Location Address
First Line	:	17314 STATE HIGHWAY 249 STE 230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-1140
Country	:	US
Telephone Number	:	832-895-3400
Fax Number	:	832-895-0293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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