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NPI Code Detail

MEDICARE: HEATHER JO KLINE FNP-C

MEDICARE: HEATHER JO KLINE FNP-C
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 PractitionerAP131194TX
2363LF0000XFamily Nurse PractitionerAP131194TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18961NYOTHERTXBLUE CROSS BLUE SHEILD

General Provider Information

NPI Number : 1699127951
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER JO KLINE FNP-C
Provider Business Mailing Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-645-4673
Fax Number :
Provider Business Practice Location Address
First Line : 505 S NOLEN DR
Second Line : STE A
City : SOUTHLAKE
State : TX
Zip : 76092-9167
Country : US
Telephone Number : 817-424-1525
Fax Number : 817-424-3491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2016
Last Update Date : 09/28/2022

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Directions to “ HEATHER JO KLINE FNP-C” Practice Location

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