Provider Demographics
NPI:1013382969
Name:MELL, HEATHER MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:MELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-7521
Mailing Address - Country:US
Mailing Address - Phone:912-712-2550
Mailing Address - Fax:912-480-0518
Practice Address - Street 1:1601 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-7521
Practice Address - Country:US
Practice Address - Phone:912-712-2550
Practice Address - Fax:912-480-0518
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19787363LF0000X
GA207922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily