MEDICARE: HEATHER SIMCHA KEIZMAN WHCNP

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	363LW0102X	Women's Health Nurse Practitioner	708708	TX

General Provider Information

NPI Number	:	1841366978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER SIMCHA KEIZMAN WHCNP

Provider Business Mailing Address
First Line	:	8800 LITTLE LAURA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-6862
Country	:	US
Telephone Number	:	512-917-9689
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 RED RIVER ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1412
Country	:	US
Telephone Number	:	512-471-3494
Fax Number	:

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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