Provider Demographics
NPI:1841366978
Name:KEIZMAN, HEATHER SIMCHA (WHCNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:SIMCHA
Last Name:KEIZMAN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 LITTLE LAURA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-6862
Mailing Address - Country:US
Mailing Address - Phone:512-917-9689
Mailing Address - Fax:
Practice Address - Street 1:1700 RED RIVER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1412
Practice Address - Country:US
Practice Address - Phone:512-471-3494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708708363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health