Provider Demographics
NPI:1407292212
Name:HUNSTABLE, HEATHER A (FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:HUNSTABLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:LUCHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-726-5323
Practice Address - Street 1:400 ROSALIND REDFERN GROVER PKWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-221-2165
Practice Address - Fax:806-723-6532
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17512363LF0000X
TXAP128245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX372602801Medicaid
NM03782824Medicaid
TX577532YKT8OtherMEDICARE
TX1407292212OtherFIRSTCARE
TX8490MCOtherBCBSTX