Provider Demographics
NPI:1376071399
Name:DOSS, HEATHER LEEANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LEEANN
Last Name:DOSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3030 W PICACHO AVE
Mailing Address - Street 2:STE D
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-4721
Mailing Address - Country:US
Mailing Address - Phone:915-525-5810
Mailing Address - Fax:915-525-5810
Practice Address - Street 1:4672 SONOMA RANCH BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:575-556-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-03
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03340363LF0000X
TXAP127444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily