Provider Demographics
NPI:1205409745
Name:SEPTOR, HEIDI (APN)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SEPTOR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2415
Mailing Address - Country:US
Mailing Address - Phone:706-861-4508
Mailing Address - Fax:
Practice Address - Street 1:93 ROBIN RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2415
Practice Address - Country:US
Practice Address - Phone:706-861-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29931363LF0000X
GARN277081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN29931OtherAPN
GARN277081OtherAPN