MEDICARE: DEBORAH MICHELLE HLAVIN FNP

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	363LF0000X	Family Nurse Practitioner	AP142146	TX

General Provider Information

NPI Number	:	1548878820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH MICHELLE HLAVIN FNP

Provider Business Mailing Address
First Line	:	4037 CRESTMONT DR
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-2073
Country	:	US
Telephone Number	:	979-204-5403
Fax Number	:

Provider Business Practice Location Address
First Line	:	4630 LONG PRAIRIE RD STE 210
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1964
Country	:	US
Telephone Number	:	469-495-9112
Fax Number	:

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

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	09/17/2024

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