Provider Demographics
NPI:1417669193
Name:NEGOSLAWSKI, HEATHER DEE (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DEE
Last Name:NEGOSLAWSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 E UNIVERSITY DR STE 50
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2390
Mailing Address - Country:US
Mailing Address - Phone:972-987-0458
Mailing Address - Fax:
Practice Address - Street 1:2381 E UNIVERSITY DR STE 50
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2390
Practice Address - Country:US
Practice Address - Phone:972-987-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1101438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily