Provider Demographics
NPI:1265667760
Name:AYERS, HEATHER CRANE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CRANE
Last Name:AYERS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:CRANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:163 SULLIVAN DR
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:GA
Mailing Address - Zip Code:30547-2256
Mailing Address - Country:US
Mailing Address - Phone:706-865-2134
Mailing Address - Fax:706-243-4613
Practice Address - Street 1:3674 HABERSHAM MILL RD
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-2811
Practice Address - Country:US
Practice Address - Phone:706-754-2630
Practice Address - Fax:706-754-2634
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN164694363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA191004405DMedicaid
GA527586OtherWELLCARE
GA01313996OtherAMERIGROUP
GA191004405BMedicaid
GA191004405CMedicaid
GA527606OtherWELLCARE
GA191004405AMedicaid
GA527602OtherWELLCARE
GA191004405EMedicaid
GA527595OtherWELLCARE
GA191004405AMedicaid