Provider Demographics
NPI:1790876746
Name:HSU, HEATHER MURRAY (FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MURRAY
Last Name:HSU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1601 W HEBRON PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6342
Mailing Address - Country:US
Mailing Address - Phone:724-268-6759
Mailing Address - Fax:972-492-4694
Practice Address - Street 1:1601 W HEBRON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6342
Practice Address - Country:US
Practice Address - Phone:724-268-6759
Practice Address - Fax:972-492-4694
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707691363LF0000X
TXAP115000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184476301Medicaid
TX184476305Medicaid
TX184476302Medicaid
TX184476303Medicaid
TX184476303Medicaid
TX8L4377Medicare PIN
TXTXB124190Medicare PIN
TX8J2439Medicare PIN
TX8L4414Medicare PIN