Provider Demographics
NPI:1164969937
Name:HARNER, HEATHER (CNM)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HARNER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:44 BLAKELY CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-1969
Mailing Address - Country:US
Mailing Address - Phone:404-391-5770
Mailing Address - Fax:
Practice Address - Street 1:5780 PEACHTREE DUNWOODY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1554
Practice Address - Country:US
Practice Address - Phone:404-255-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
GARN220772367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife