Individual
HEATHER L LACROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
7544 JACQUE RD, HUDSON, FL 34667-7162
(727) 697-2200
Mailing address
7544 JACQUE RD, HUDSON, FL 34667-7162
(727) 697-2200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP 3086652
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP3086652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304367300
—
FL
01
—
Y0E26
BCBS
FL
Enumeration date
06/17/2005
Last updated
07/08/2021
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