Provider Demographics
NPI:1164201844
Name:BURKLEO, HEATHER D (APRN- CNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:BURKLEO
Suffix:
Gender:F
Credentials:APRN- CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BOIS D ARC ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-1903
Mailing Address - Country:US
Mailing Address - Phone:903-564-3366
Mailing Address - Fax:
Practice Address - Street 1:109 BOIS D ARC ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-1903
Practice Address - Country:US
Practice Address - Phone:903-564-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty