Provider Demographics
NPI:1073858338
Name:HURFORD, HEATHER LYNNE (RN, MSN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNNE
Last Name:HURFORD
Suffix:
Gender:F
Credentials:RN, MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6163
Mailing Address - Fax:
Practice Address - Street 1:4200 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1400
Practice Address - Country:US
Practice Address - Phone:817-750-7334
Practice Address - Fax:210-314-5044
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743287363LP0200X
TXAP122617363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics