Provider Demographics
NPI:1164808713
Name:CUMMINS, HEATHER E (APN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:E
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:131 SAUNDERSVILLE RD
Mailing Address - Street 2:STE 160
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-8903
Mailing Address - Country:US
Mailing Address - Phone:423-458-6267
Mailing Address - Fax:423-790-7136
Practice Address - Street 1:501 ADESA BLVD
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6725
Practice Address - Country:US
Practice Address - Phone:865-286-9977
Practice Address - Fax:865-286-9967
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ015610Medicaid
TNQ015610Medicaid