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NPI Code Detail

MEDICARE: HEATHER L LACROSS ARNP

MEDICARE: HEATHER L LACROSS ARNP
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
1363L00000XNurse PractitionerARNP 3086652FL
2363LP2300XPrimary Care Nurse PractitionerARNP3086652FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y0E26OTHERFLBCBS

General Provider Information

NPI Number : 1285639021
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER L LACROSS ARNP
Provider Business Mailing Address
First Line : 7544 JACQUE RD
Second Line :
City : HUDSON
State : FL
Zip : 34667-7162
Country : US
Telephone Number : 727-697-2200
Fax Number :
Provider Business Practice Location Address
First Line : 7544 JACQUE RD
Second Line :
City : HUDSON
State : FL
Zip : 34667-7162
Country : US
Telephone Number : 727-697-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/08/2021

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Directions to “ HEATHER L LACROSS ARNP” Practice Location

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