Provider Demographics
NPI:1750781787
Name:ORTIZ, HEATHER (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ORTIZ
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 1:7111 BOSQUE BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4071
Mailing Address - Country:US
Mailing Address - Phone:254-307-3997
Mailing Address - Fax:254-300-9935
Practice Address - Street 1:7111 BOSQUE BLVD STE 303
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4071
Practice Address - Country:US
Practice Address - Phone:254-307-3997
Practice Address - Fax:254-300-9935
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990261-NP363LF0000X
TXAP136978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily