Provider Demographics
NPI:1437569548
Name:HASARA, HEATHER LEE (APRN, CPNP-PC,FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEE
Last Name:HASARA
Suffix:
Gender:F
Credentials:APRN, CPNP-PC,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12235 LITTLE BLUE HERON LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1689
Mailing Address - Country:US
Mailing Address - Phone:936-236-9147
Mailing Address - Fax:
Practice Address - Street 1:12235 LITTLE BLUE HERON LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1689
Practice Address - Country:US
Practice Address - Phone:936-236-9147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX806376163WL0100X
TXL-50770163WL0100X
TX1059420363LP0200X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty