Provider Demographics
NPI:1851983670
Name:HULL, HEATHER D (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:D
Last Name:HULL
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 1:2219 TALLOW DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-3051
Mailing Address - Country:US
Mailing Address - Phone:682-203-9004
Mailing Address - Fax:
Practice Address - Street 1:1A BURTON HILLS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6187
Practice Address - Country:US
Practice Address - Phone:615-665-1283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019800363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care