Provider Demographics
NPI:1326823899
Name:TREHERN, HEIDI WILHELM (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:WILHELM
Last Name:TREHERN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 MACEDONIA RD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-6107
Mailing Address - Country:US
Mailing Address - Phone:678-673-7169
Mailing Address - Fax:
Practice Address - Street 1:222 GORDON ST
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-1519
Practice Address - Country:US
Practice Address - Phone:770-537-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily