Provider Demographics
NPI:1861000176
Name:FLIPPIN, HEATHER NICOLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICOLE
Last Name:FLIPPIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3517 LCR 723
Mailing Address - Street 2:
Mailing Address - City:KOSSE
Mailing Address - State:TX
Mailing Address - Zip Code:76653-3935
Mailing Address - Country:US
Mailing Address - Phone:254-495-2866
Mailing Address - Fax:254-729-7927
Practice Address - Street 1:206 N NARCISSUS
Practice Address - Street 2:
Practice Address - City:KOSSE
Practice Address - State:TX
Practice Address - Zip Code:76653
Practice Address - Country:US
Practice Address - Phone:254-275-7001
Practice Address - Fax:254-375-2233
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1004019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily