Provider Demographics
NPI:1780379859
Name:SPENGLER, HEATHER LYNN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:SPENGLER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 AIMSLEY CT APT 615
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-8046
Mailing Address - Country:US
Mailing Address - Phone:217-855-0659
Mailing Address - Fax:
Practice Address - Street 1:4016 GATEWAY DR STE 120
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5960
Practice Address - Country:US
Practice Address - Phone:817-283-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1107529363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health