Provider Demographics
NPI:1881945830
Name:ATKINS, HETTA (ACNP)
Entity type:Individual
Prefix:DR
First Name:HETTA
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:MISS
Other - First Name:HETTA
Other - Middle Name:KATE
Other - Last Name:HUCKABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4522 FREDERICKSBURG RD STE A14
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-6595
Mailing Address - Country:US
Mailing Address - Phone:210-733-3005
Mailing Address - Fax:
Practice Address - Street 1:4522 FREDERICKSBURG RD STE A14
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6595
Practice Address - Country:US
Practice Address - Phone:210-733-3005
Practice Address - Fax:210-733-3001
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-29
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683687363LA2100X
TXAP122325363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care