Provider Demographics
NPI:1245437193
Name:HEATH, LANA M (FNP)
Entity type:Individual
Prefix:MRS
First Name:LANA
Middle Name:M
Last Name:HEATH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6010
Mailing Address - Country:US
Mailing Address - Phone:318-397-3664
Mailing Address - Fax:
Practice Address - Street 1:1001 W SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6010
Practice Address - Country:US
Practice Address - Phone:817-310-0421
Practice Address - Fax:817-310-5870
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily