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Individual

HEATHER JO KLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
505 S NOLEN DR, STE A, SOUTHLAKE, TX 76092-9167
(817) 424-1525
(817) 424-3491
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 645-4673

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP131194
TX
363LF0000X
Family Nurse Practitioner
AP131194
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8961NY
BLUE CROSS BLUE SHEILD
TX
Enumeration date
07/11/2016
Last updated
09/28/2022
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